Tuberculosis hospital and sanatorium construction - Tucson Historic

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Tuberculosis hospita Pi'a

r

RECAP

luberculosis

Hospital and Sanatorium

Construction WRITTEN FOR

THE NATIONAL ASSOCIATION FOR THE STUDY AND PREVENTION OF TUBERCULOSIS

BY

THOMAS SPEES CARRINGTON,

M.D.

ASSISTANT SECRETARY

J.***

*

^)

NEW YORK 105

EAST TWENTY-SECOND STREET 1911

/Q

4f-

Columbia ^ntoersiftp in tije Citp of ^cto ^orfe

CoUege of ^ft psiciang anb ^urgconsi

i^eference I^ibrarp

Adirondack Cottage Sanitarium, Trudeau, N. Y. The Original Oxe-roum Cuttage where \)R. Edward L. Trudeau began his Experiment with the Open-air Treatment OF Tuberculosis.

Tuberculosis Hospital and Sanatorium

Construction WRITTEN' FOR

THE NATIONAL ASSOCIATION FOR THE STUDY AND PREVENTION OF TUBERCULOSIS

BY

THOMAS SPEES CARRINGTON,

M.D.

ASSISTANT SECRETARY

NEW YORK 105

EAST TWENTY-SECOND STREET 1911

Preface The present work

is

an expansion of the pamphlet issued two years ago by

the National Association for the Study and Prevention of Tuberculosis in response

demand

to a pressing

and

for information

and advice

in the establishment of sanatoria

hospitals.

During this period the emphasis of the campaign has been laid particularly upon the importance of increasing our equipment for the institutional care of tuberculous patients.

The response has exceeded expectation and has been

ticularly encouraging in the degree to

which

accepted responsibility for the situation.

local

is

it is

par-

governments have

true that institutional expense

tenance than of original cost of construction

it is

is

of

to care for the largest possible

of patients at the lowest possible cost compatible

While

state

Under these conditions the problem

tuberculosis from the institutional point of view

number

and

with

much more

efficient results.

a matter of main-

equally true that careful prelim-

is the chief factor in subsequent economy of operation. It is with end in view that the following study has been prepared. It is hoped that the book will prove of service to those charged with the

inary planning this

responsibility of dealing with the institutional

problem

in their several

communities.

Livingston Fareand,

May

Executive Secretary. ijth, igii

Digitized by the Internet Archive in

2010 with funding from

Open Knowledge Commons

http://www.archive.org/details/tuberculosishosOOcarr

Contents PAGE

Introduction Section

I.

14 Site

and Grouping

.

.

.

.

.

.

.



17

Transportation Facilities; Extent and Nature of the Land; Lighting, Water and Sewage; Meterological Conditions; Natural Beauty; Examination of the Land; Farm Buildings; Grouping; Cleaning and Apportioning Grounds; Railroad Station; Buildings and Improvements for Block Plan; Sites for Hospitals to House Advanced Cases; Examples of Grouping and Sites.

Sanatorium

II.

Sites;

Administration Buildings

.

.

.

.

.

.

-37

Methods of Sanatorium Administration; Planning Administration Buildings; Class and Number of Patients; Staff and Servants' Housing; Staff and Servants' Salaries; Service Buildings; Amusement Pavilions; Industrial Buildings; Water Supplies; Light, Heat and Power; Laundries; Sterilizing Rooms; Vacuum Cleaning Plants; Ice Houses and Cold Storage Plants; Carpenter and Paint Shops; Store Houses, Bakeries and Scale Houses; Green Houses, Forcing Beds, Vegetable Cellars; Garages, Barns and Stables; Farm Outfits; Cow-barns; Silos; Milk Houses; Chicken and Hog Houses; Sewage Disposal Plants; Examples of Administration Buildings; Examples of Service Buildings.

III.

Administration Buildings and Patients' Quarters Combined

.

69

Suggestions for Planning Buildings; Examples of Complete Institutions under One Roof.

IV.

Hospitals for Hospitals

.........

Advanced

Cases.

Infirmaries

and

Reception 89

Description of Hospitals for Advanced Cases; Description of Infirmaries; Description of Reception Hospitals; Examples of the Buildings at Various Institutions.

V.

Patients' Quarters.

Lean-to Type of Building

.

.

-117

Origin of These Buildings; Material; Finish; Excavation; Exposure; Arrangement of Floor Plans; Porch Space; Porch Protection; Ventilation; Fixtures; Plumbing; Examples of Lean-tos.

VI.

Patients' Quarters.

Cottage Type of Building.

.

.

.

Origin of These Buildings; Points to be Considered in Designing Cottages; Examples of Cottages.

147

Illustrations

Frontispiece

— Dr.

Trudeau's Original Cottage.

SECTION

I

Site and Grouping

Loomis Sanatorium, Liberty, N. Y., V^iews of a Farmhouse before and after Remodeling Views of Land Showing Natural Features of Value on Sites for Sanatoria

.... ....

Mar>'land State Sanatorium, Sabillasville,

Md

Bird's-eye View Georgia State Sanatorium, Alto, Ga.,

Block Plan

26 27

Waverly HiU Sanatorium, Waverly Hill, Ky., Front Elevation and Block Plan Agnes Memorial Sanatorium, Denver, Colo., Front Elevation and Block Plan

28

.

29

.

Indiana State Hospital, Rockville, Ind., Bird's-eye View and Block Plan Portland Open Air Sanatorium, Portland, Ore. Block Plan \'ermont State Sanatorium, Pittsford, Vt., View of Front Elevation and Block Plan Essex County Tuberculosis Hospital, Soho, N. J., View of Buildings and Block Plan Maine State Sanatorium, Hebron, Me., Block Plan Preventorium for Children, Farmingdale, N. J., Bird's-eye View of Building and Block Plan

30

....

SECTION

31

32 33

34 35

II

Administration Buildings

....

14

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Amusement Pavilion; Views and Plans. Municipal Sanatorium, Otisville, N. Y.,

15

An Open

16

Portland Open Air Sanatorium, Portland, Ore.,

13

17

18

..... ........ ...... ......

Servants' Open Air Sleeping Pavilion Air Dining Room

Amusement Pavilion; Interior Catawba Sanatorium, Catawba, Va., A Method of Storing Water. Waverly Hill Sanatorium, Waverly Hill, Ky., View from Rear of Buildings Showing Power House Preventorium

21

Farmingdale, N. J., Power House and Laundry; Elevations and Floor Plans District Tuberculosis Hospital, Lima, Ohio, Floor Plan of Basement Showing Arrangement of Power Plant A Rectangular Steam Disinfecting Chamber

22

Eudowood Sanatorium, Tow.son, Md.,

iQ

20

23

24 25

40 41 42 43

44 46

for Children,

.....

Administration Building; View and Floor Plans Maine State Sanatorium, Hebron, Me., Administration Building; View and Floor Plans Iowa State Sanatorium, Oakdale, la., .\dministralion Building; View and Floor Plans Manitoba Sanatorium, Ninette, Manitoba, Canada, Administration Building; Views and Floor Plans

26

Indiana State Hospital, Rockville, Ind.,

27

-Administration Building; View and Floor Plans Preventorium for Children, Farmingdale, N. J., .Administration Building; Elevation and Floor Plans

47

48 5° 55

57 S8

59 61

62

Illustrations No. 28 29

30

Municipal Sanatorium,

Otisville, N. Y., Service Building; View and Floor Plans Iowa State Sanatorium, Oakdale, la., Service Building; Views and Floor Plans Catawba Sanatorium, Catawba, Va., Service Building; Elevation and Floor Plan New Haven County State Sanatorium, Meriden, Conn., Service Building; View and Floor Plans

64 65

66

.

31

SECTION

67

III

Administration Buildings and Patients' Quarters Combined 32 ^^

34 35

36

Eastern Maine Hospital, Bangor, Me.,

Method of Protecting Sleeping Porch with Wire Netting Hospital for Insane, Washington, D. C, Method of Enclosing Porch, with Swinging Sash Frames Sharon Sanatorium, Sharon, Mass., View and Floor Plan Tuberculosis Hospital, Washington, D. C, View of Front Elevation Tuberculosis Hospital, Washington, D. C, Floor Plans Lady Grey Hospital, Ottawa, Canada, View and Floor Plans Lake Edward Sanatorium, Lake Edward, Quebec, Canada, View and Floor Plans Franklin County Tuberculosis Hospital, Columbus, Ohio, Elevation and Floor Plans Hartford County Tuberculosis Sanatorium, Hartford, Conn., View and Floor Plans Cuenca Sanatorium, -Bass Lake, Minn., Elevation and Floor Plans Association Sanatorium, Colorado Springs, Colo., Elevation and Floor Plans District Tuberculosis Hospital, Lima, Ohio, Views and Floor Plan A Design for a Small Town or Village Hospital, Elevation and Floor Plan U.

S.

.

37

38 39

40 41

...... ..... ... ...... ...... ..... ...... .

.

.

42

.

...... ..... .

43

44

...

.

.

.

SECTION IV Hospitals for Advanced Cases 45

Comparison

—Infirmaries

and Reception Hospitals

Reception Hospitals, and

of the Floor Plans of Infirmaries,

Buildings Housing Advanced Cases Indiana State Hospital, Rockville, Ind., A Method of Connecting Rooms with Open Porches Isolation Hospital, Paterson, N. J., A Method of Heating Porches for Advanced Cases .

46 47

48 49 50 51

52 53

54 55

56 57

Riverside Hospital,

New York

City,

Concrete Pavilion; Elevation and Floor Plans Jewish Hospital for Consumptives, Reisterstown, Md., Pavilion for Advanced Cases; Views of Elevations Jewish Hospital for Consumptives, Reisterstown, Md., Pavilion for Advanced Cases; Floor Plans Indiana State Hospital, Rockville, Ind., Pavilion for Advanced Cases; View and Floor Plans Isolation Hospital, Paterson, N. J., Pavilion for Advanced Cases; View and Floor Plans United States Army General Hospital, Ft. Bayard, N. M., Officers' Quarters; View and Floor Plan United States Army General Hospital, Ft. Bayard, N. M., Enlisted Men's Ward No. 2; View and Floor Plan. United States Army General Hospital, Ft. Bayard, N. M., Enlisted Men's Ward No. 2; View of Inner Court Lakeville Tuberculosis Hospital, Middleboro, Mass., Pavilion for Advanced Cases; View and Floor Plan Boston Consumptives Hospital, Mattapan, Mass., Ward for Advanced Cases; View and Floor Plan Maine State Sanatorium, Hebron, Me., Infirmary; View and Floor Plan

....

.

58

.

Illustrations Xo.

50

60 61

62 63

64

Municiijal Sanatorium. Otis\ille. X. Y., Infirmary; \'ie\vs of Front and Rear Elevations Municijial Sanatorium, Otis\ille, N. Y., Inhrmar}-; Floor Plans

......

Eudowoocl Sanatorium, Towson, Md., Infirmary; \'ie\vs and Floor Plan Edward Sanatorium. Xaperville, 111., Infirmary and ^Medical Building; View and Floor Plans Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Infirmary and ^Medical Building; View and Floor Plans Mar\-land State Sanatorium, Sabillasville, Md., Infirmary; Mew and Floor Plans

....

65

Georgia State Sanatorium, Alto, Ga., Infirmary; View and Floor Plan

66

Danvers State Hospital, Hawthorne, 2\Iass., Paxilion; \'iew of Elevation and Floor Plan Ohio State Sanatorium, Mt. Vernon, Ohio, Reception Hospital; View and Floor Plan

67

.

SECTION V P.\TIENTS' Qu.^RTERS

68 69 70 71

73

74 75

76 77

78 79

80 81

82

TyPE OF BuiLDING FOR INCIPIENT

Illustrating a

Method

84 85

86 87 88

of Protection

Loomis Sanatorium, Liberty, N. Y., Open Porch, Showing a Method of Interior Finish Loomis Sanatorium, Liberty, N. Y., Lean-to; View and Floor Plan Michigan State Sanatorium, Howell, Mich., Lean-to; View and Floor Plan Marjdand State Sanatorium, Sabillasville, Md., Lean-to; View, Cross-Section and Floor Plan Delaware State Sanatorium, Wilmington, Dela., Lean-to; \'iew and Floor Plan Ohio State Sanatorium, Mt. Vernon, Ohio, Lean-to; View and Floor Plan

Georgia State Sanatorium, Alto, Ga., Design for a Lean-to New Haven County State Sanatorium, Meriden, Conn., Lean-to; View and Floor Plans Catawba Sanatorium, Catawba, Va., Lean-to; View and Floor Plan Manitoba Sanatorium, Ninette, Manitoba, Canada, Lean-to; \'iew and Floor Plan Edward Sanatorium, Napen,ille, 111., Lean-to; View and Floor Plan Eudowood Sanatorium, Towson, Md., Lean-to; \'iew and Floor Plans Iowa State Sanatorium, Oakdale, la.. Lean-to; \'iew and Floor Plan Municipal Sanatorium, Otisville, X. Y., Lean-to; View and Floor Plan Association Sanatorium, Louisville, Ky., Lean-to; View and Floor Plan North Reading State Sanatorium, North Reading, Mass., Lean-to; View, Cross-Section and Floor Plan Edward Sanatorium, Naperville, 111., Lean-to; \'iew and Floor Plan .

90 91

.....

.

.

...

.....

....... ........ ........ .

89

...

.

........ ........ ..... ........ ........ .......... ........ ........ ........ ........ ........ ........ ........ .

83

C.\SES

........

Comparison of Floor Plans of the Lean-to Type of Buildings for Housing Incipient Cases Catawba Sanatorium, Catawba, Va., An Open Porch Illustrating Simplicity of Construction North Reading State Sanatorium, North Reading, Mass., An Open Porch Illustrating a Method of Protection Mrginia State Farm, Richmond, Va.,

Open Porch, 72

^LeAN-TO

Iowa State Hospital, Mt. Pleasant, la.. Lean-to; Elevation and Floor Plan Rush Hospital, Country Branch, Malvern, Lean-to; View and Floor Plans Loomis Sanatorium, Liberty, N. Y.^ Lean-to; Mew and Floor Plan

Pa.,

.

.

.

.

.

Illustrations No. 92

93

04 95

.... ....

Michigan State Sanatorium, Howell, Mich., Design for a Lean-to New Yorlv State Hospital, Raybrook, N. Y., Design for a Lean-to ISIunicipal Sanatorium, Otisville, N. Y., Lean-to; View and Floor Plans Preventorium for Children, Farmingdale, N. Lean-to; Elevation and Floor Plans

143 143

144 J.,

145

SECTION VI Patients' Quarters 96 97

— Cottage

Type of Building

....

Millet Sanatorium, East Bridgewater, Mass., Cottage; View, Cross-Sections and Plans Rush Hospital, Country Branch, Malvern, Pa., Cottage View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y. ;

98

99 100 loi

102

103

104 105

Cottage; View and Floor Plan Association Sanatorium, Louisville, Ky., Cottage; View and Floor Plan

107 108

109

no

.

ISO 151



152

White Haven Sanatorium, White Haven, Pa., Cottage; View and Floor Plan Municipal Sanatorium, Otisville, N. Y. Cottage; View and Floor Plan Plainfield General Hospital, Plainfleld, N. J., Cottage; View and Floor Plan Iowa State Sanatorium, Oakdale, la., Cottage; View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Wheeler Cottage; View and Floor Plan Gaylord Farm, Wallingford, Conn., Connected Cottages; View and Floor Plans Barlow Sanatorium, Los Angeles, Cal., Cottage; View and Floor Plan .

106

149



......

Portland Open Air Sanatorium, Portland, Ore., Cottage; Views Loomis Sanatorium, Liberty, N. Y., Orchard Cottage; View and Floor Plan Adirondack Cottage Sanitarium, Saranac Lake, N. Y;, Nathan Cottage; View and Floor Plan, River Pines Sanatorium, Stevens Point, Wis., Cottage; View and Floor Plan

13

153 •



.



.



154 15s

156 157

158 159

160 162 .

163

164

Introduction hoped that

It is

this

work

will

be found useful by those

who

desire to design

and

construct hospital and sanatorium buildings for the care of tuberculous patients.

The information presented has been

collected during a series of investigations into

the methods and materials used in the construction of buildings at various institutions

This book all varieties and stages of tuberculous disease. and expansion of the original pamphlet on construction, "Some Plans and Suggestions for Housing Consumptives," published in 1909 by the National Association for the Study and Prevention of Tuberculosis, and includes the results of studies made on the question of sites, in order to determine in some degree the effect of location and During the past surroundings from both the cUnical and economic points of view.

where patients are treated for

is

a development

two years, in a number

of states, legislation

has been enacted authorizing counties to

establish institutions for the treatment of tuberculous patients.

movement has brought about many new problems and sanatoria, and

hospitals

might help

it

The

rapid growlh of this

and maintenance work such material

in the construction

has been the aim to

embody

in this

of

as

in the solution of these difficulties.

Cost of Construction It is the opinion of the majority of those who have had experience in constructing and administering tuberculosis hospitals and sanatoria, that it is wise to build in a comparatively inexpensive manner. Excellent results have been obtained by the open-air method of treating tuberculous patients in institutions built on simple and economical plans; and further, this class of institutions returns patients to their homes without making them unduly discontented with the environment and life to which they belong. It may therefore Ije said that those who adhere to simplicity and economy in sanatorium construction and furnishing, and who supply patients with good wholesome food, cleanliness, light employment, and a happy, friendly atmosphere, are operating along modern and approved lines.

One

of the first questions

incipient cases or a hospital for

funds it

will

may

asked when the establishment

advanced cases

is

of either a

sanatorium for

proposed in a community,

be needed for constructing and maintaining the institution?"

is,

"What

In general terms

be stated:

A

Sanatorium

for Incipient Cases,

having a capacity

of fifty patients, will cost to

build and ef|uip (exclusive of the land) $25,000 and upward.

A Hospital for Advanced Cases, having a capacity of fifty patients, will cost to and equip (exclusive of land) $50,000 and u})ward. A Hos[)ital for Both Classes of Cases, having a capacity of fifty patients, will cost build and equip (exclusi\-e of land) $35,000 and upward.

build

t(j

In other words,

it

will cost to

build

and

ec[uip a

complete institution for Incipient

Cases about $500 per bed; for Advanced Cases $1,000 per bed; and for Both Classes of

Cases

in the

same

institution

$750 per bed. 14

Introduction Cost of Administration Buildings Administration buildings for an institution housing

fifty

patients can be constructed

and upward, the cost depending upon the material used and the

for $12,000

exterior

and

interior finish.

Cost of Infirmaries and Pavilions for Advanced Cases Infirmaries and pavilions for advanced cases, having a capacity of twenty patients

housed

can be constructed for $10,000 and upward.

in single rooms,

Cost of Lean-tos Lean-tos having a capacity of sixteen incipient cases can be constructed for $800

and upward.

Examples The expended

of Appropriations following

list

is

given in order to show how, in an actual case, $100,000 was

for the construction of a State

of all classes except the

Sanatorium housing one hundred and

Administration Building Four Lean-tos (each $3,500) Two Wards for Advanced Cases (each $7,000) Power House and Heating Plant Sewage Disposal Plant Water Pumping and Supply Plant

2,000 5,ooo

3,300 7,000 1,200

Furnishings

Laundry

Land

(Site)

Expenses

of Building

5,500 11,500

Commission

Total

The

patients

$31,500 14,000 14,000 5, 000

and Machinery

Boilers

fifty

very far advanced cases.

$100,000

is cited in order to show the distribution of an appropriation for the County Hospital having a capacity for fifty patients, of all classes.

following

construction of a

Site, Water Supply and Sewage Disposal Administration Building Advanced Case Pavilion (Twenty Beds) Two Incipient Case Pavilions ($2,500 each)

Total

Arrangement

Many

.

of the Floor

$10,000 16,000 10,000 5, 000 $41,000

.•

Plans for Administration Buildings

Administration Buildings constructed for Tuberculosis Hospitals or Sanatoria

have been designed on general hospital

lines.

This has not proven to be the most

factory type of building for administrative purposes, as the medical

vants are often arrested or cured cases of tuberculosis.

staff,

satis-

nurses and ser-

Administration buildings that

seem best adapted for institutions of this class, are those constructed so that all persons housed in them may have, if desired, individual open-air sleeping porches. For this reason, it is

the opinion of

of the

many

open type; that

is

authorities that

all

buildings for tuberculosis institutions should be

to say, with walls pierced

floors to the ceiling as possible,

and

all

by

as

many windows

reaching from the

apartments arranged so that they 15

may

be thrown

Introduction open on at

least

two

sides.

Amusement

halls, readino;,

dining and sitting rooms, which are

constructed as small individual buildings, and arranged to be opened on

all

sides

weather permits, are being erected in greater numbers, and prove satisfactory. used by the adniinistrati\'e departments, except in are said to gi\-e better ser\'ice sites are large

when

cities or

towns where land

when

is

valuable,

Where

from the patients' quarters.

entirely separated

the

Buildings

enough, one-story buildings, even for administrative purposes, are becoming

popular.

Arrangement

Plans for Pavilions for Advanced Cases

of Floor

Paxdlions for advanced tuberculous cases have also, in the past, been constructed in the

same manner

as general hospital wards,

but as

it

has been found that

many advanced

tuberculous patients, with proper care, quickly improve under the open-air treatment, these buildings are

and

now being planned

indi\'idual

Arrangement

rooms pro^'ided of Floor

so that

open porch space

for all far

advanced

may be

allotted to

all

the inmates,

cases.

Plans for Lean-tos

The only changes

of

importance, during the past months,

made

in designing the

and on the open sleeping porches in order to house the patients in smaller groups. It may be said that practically all new designs call for lockers which are large enough to be used as private dressing rooms, and in many instances fitted with a chest of drawers, a mirror, racks for toilet articles, and other conveniences.

lean-to t}^e of building, have been in the pro\dsion of larger lockers for each patient, in placing transverse partitions

Transportation

The importance

of keeping

down

the cost of maintaining an institution after

it is

and planning the buildings. Transportation expense is one of the larger factors in this problem, and it is becoming clearer that public institutions must be placed on or near good transportation faciUties. In a number of instances, railroad companies have ^\illingly put in spurs or sidings free of charge, as the sites chosen were near their right-of-way, and it is advisable that authorities, considering erected, should be always before those selecting the site

the establishment of a sanatorium or hospital, consider this question with care before pur-

chasing an otherwise desirable property.

T.

i6

S.

C.

SECTION Site

I

and Grouping

SECTION Site

I

and Grouping

Sanatorium Sites site in the open country for a tuberculosis sanatorium, to house inand moderately advanced cases, a decision must be made as to whether the ad\'antage of having the patients near at hand and accessible to their friends overweighs the possible benetit to be obtained by placing the institution in a region more favorable from a

In selecting a

cipient

climatic point of view, but far from the patients' homes. in the

It

is

now

generally agreed that

treatment of tuberculosis excellent results can be obtained in practically any section

of the country

and the desirability of local Within a short distance

established fact.

obtained where tuberculous patients

will

do

institutional provision can be accepted as of

an

almost every city and town, land can be

well.

Transportation Facilities Transportation

facilities

should always be carefully considered, as a long haul from

the railroad or landing adds expense both in building and maintenance.

Probably

in the

near future most of the institutions founded with the intention of housing over one hundred patients, will be placed

upon land that can be reached without great expense by a private

branch or spur from the nearest railroad, or by some other means of public transportation.

A

site

on a direct

friends.

trolley line

It is often

is

very desirable in order to make

hard to hold consumptives

like to leave their families,

of the patients are

the location

will

it

accessible to the patients'

sanatorium, for the very sick do not

and many incipient patients become

pelled to drop their regular occupations.

most

in a

If

drawn and where by

a sanatorium

is

when first comtowns from which

restless

close to the

a short trolley trip visitors can reach

it

easily,

help very largely in making the patients contented.

Extent and Nature of the Land

The it will

site

should be a tract of land from twenty to two hundred acres in extent and

be more valuable for

cultivated.

It is

are supplied with efficient

now

its

purpose

if it

includes forest, orchard

and land that can be

generally conceded that incipient patients improve faster

work under

careful supervision,

medical superintendent, they

will

and

at

many

sanatoria,

if

when they by an

directed

be able to do a considerable part of the farm work

with real benefit to themselves and a reduction in the cost of their maintenance. there

is

a choice of a

land when selected

while the natural advantages of another property

provement

is

not necessary.

tion of possible land

When

number of sites, a damp or swampy location should be avoided, as such must be drained. The expense of preparing some land is very great,

made

For these reasons

before

it is

may

it is

chosen as a

be such that a large outlay for im-

advisable to have a thorough examina-

site for

a sanatorium.

Site

Water and Sewage

Lighting,

A good supply of water is is

well,

if

and Grouping

a necessity,

and

for this reason

when

building near a city

possible, to secure property within the line of the city water supply

systems, thus settling the question of water, sewage disposal and lights.

On

all

it

and sewer other land

considered there should be good springs, a running stream of clear water, or the possibility of obtaining it

by

driN-ing a

The

thoroughly protected well.

be considered before the land

is

disposal of sewage

acquired, as the quality of the

soil,

must

also

the rise of the land and

and lakes enter into the question and increase or reduce the and maintenance. These subjects are all considered more in detail under the section on administration buildings. the position of water courses

cost of installation

Meteorological Conditions very important that the meteorological conditions

of a prospective site should This means obtaining data with regard to the altitude, average humidity,

It is

be known.

number of stormy days in the year, highest and lowest degrees of heat and cold, prevailing winds and an}' atmospheric peculiarities which might affect either the patients or building materials. It is v:e\l to remember that vastly differing conditions are often found within a radius of a few miles;

Land where

therefore, such information should be gathered on the site itself.

strong winds prevail during certain seasons of the year and where hea\y frosts

occur more frequently during the winters than in other nearby localities should be avoided if

possible.

L^sually the southern exposure of a hill or

mountain

is

to be preferred.

Natural Beauty year,

The problem of holding tuberculous patients at sanatoria grows more serious each and as the institutional care of certain classes of cases seems to be an absolute necessity

in order to control the disease,

made to place patients upon sites amuse and make them contented. The

every effort should be

that have natural attractions which will help to

open country, where a sanatorium for incipient cases is generally placed, usually offers a In making a decision from choice of sites some of which may have great natural beauty. several pieces of property offered, this should be considered as a valuable asset. A sloping, rolling or hilly piece of

is

a lack of

be planned

land

is

more

desirable than a level one.

Mountains,

hills,

meadows

and a forest, lake or stream gives opportunities for A great deal can be done by artificially improving the grounds where there natural beauty, and in the selection of a site in a bare or flat country this should

and trees add amusement.

to the

beauty

of the view,

for.

Examination

of

Land

by the National Association for the Study and Prevenneeded by its Bureau of Hospital and Sanatorium Construction, may be of some assistance to those examining a property for the purpose of determining its value as a site for hospital and sanatorium purposes.

The

following questions used

tion of Tuberculosis

when asking

for information

How many

acres of land are available for Sanatorium purposes? flat, roUing, or on a hillside? What is the degree and exposure of the slope of the hills? Are there trees for protection from prevailing winds? What is the direction of the prevailing winds in summer? In winter? Is the

ground

What What

is

is

the altitude above sea level and above surrounding country? the amount of moisture precipitation per year? 19

Section

I

No. I.— Loomis Sanatorium, Liberty, N. Y. Views of a Farm-house before and after Remodeling. XoTi: the Wide Sleepim; I'orc hks Constructed on the Front of the Building in the Lower Illustrxtiox. ('See illustrations 72, 73,91 and 108 for further description of this institution.)

Site

What What What What

and Grouping

the average amount and duration of snow? the highest and lowest recorded temperature? 10. is the mean temperature of the winter months? 1 1 is the mean temperature of the summer months? 12. Is it possible to use the local water supply of the nearest town? 13. At what height on the property above or below the building site is the water supply? 14. What is the amount of water flow in gallons per minute? 15. What is the direction and size of the water courses on the property? 16. What are the lighting facilities in the neighborhood, gas, electricity, etc.? 17. What is the composition of the soil? iS. What building materials are available on or near the propert}^? Can sand, building stone, rough stone for foundation, brick, cement, lime and timber be easily obtained? 19. What are the transportation facilities, such as railroad, trolley lines, etc.? 20. Where is the principal approach to the proposed site? 21. What is the distance from the nearest saw and planing mill? 22. Are there any old buildings on the site? (Give full description with a drawing of the floor plans and photographs of the front and side elevation.) Note: Sketch-map of proposed property showing location of buildings, entrances, water-courses, etc., is very desirable. 8. g.

is is

Farm Buildings Often farm-houses or other structures stand on the land chosen and can be remodeled

make

so as to

carefully

The expense

useful sanatorium buildings.

be materially reduced

if

and unsanitary conditions corrected,

season of the year.

of constructing the institution

may

these are good, substantial structures, but they should be examined especially

if

the buildings are

damp

at

any

Careful inspection of the plumbing, drains, and cellar should always be

made by an experienced

sanitarian.

When

the walls of the cellars are damp,

should be used to obtain a circulation of air about the foundation.

some method

This can be done by a

new wall built beside the old foundation, The cellar floor should then be relaid with a foundation of broken stone, covered with cement, and openings made in the cellar walls to procure plenty of light and air. The greatest care must be used to prevent dampness trench opened on the outside of the house, and a

leaving an air space between the two waJls.

around

old buildings; in

all

in others it

may

some places a

subsoil system of drainage will be needed, while

be necessary to remove trees close to the house.

In all rooms, where there is sufficient wall space, new windows should be made, and windows cut down to the floor and up to the ceiling. Ventilation for the winter months may be obtained by building fireplaces or installing ventilating flues, and other appliances used to give a continuous change of air. Often it will be necessary to install baths and toilets and have connections made with the water supply and sewage disposal plants. Many old farm-houses are built of heavy timbers which are usually well preserved and can be repaired and put in excellent condition without great expense. When planning a rearrangement of an old building for administration purposes, a large dining room is usually the most important apartment to be provided, and often can be made by removing the partitions between rooms on the ground floor and throwing two or three together. old

Many

institutions ha^'e been started

by housing the administrative department in old room and office on the first

buildings which were only large enough for a kitchen, dining floor,

and a few rooms

for the staff

on the second.

A small

hospital started in this

way may

provide for a large number of patients.

An

old country mansion will often

make

a good administration centre for a small,

Section

No.

2.

I

The Natural Features of the Land shown in These Views Greatly Add to the Value of Property for Sanatorium Sites. Tiik Group of Buildings in the Upper Illustration IS THE liARLOW SANATORIUM. (See a description of the cottages on page 159.)

Site private sanatorium, in

many

and Grouping

cases without remodeling.

Small cottages of the Millet

type (Illustration 96), or those of the Open air Sanatorium, Oregon (Illustration 107), can then be built about the grounds for a comparatively small outlay.

The barns and

out-buildings

if

in

good condition

will also

save a considerable outlay,

for they can be used for housing cows, chickens and other domestic animals which should

be counted on to reduce the cost of maintenance.

Grouping There on the

is

sites for

undue waste

a constant

new

call for

of funds or energy.

a hospital or sanatorium after

portance than

information as to the best methods of arranging buildings

institutions in order that the plants It is to

and

made

filled

Many

the initial cost of construction.

started in a small way, additions being

and very little

be remembered that the economical operation of

finished

it is

when completed can be run without

in a

with patients,

of

is

much more

im-

existing sanatoria of large size were

haphazard manner as necessity required,

planning done except for administration buildings, power houses and patients'

quarters, before the construction of the plant

superintendents of a number of

new

was commenced. have found after

institutions

It

is

also a fact that the

their plant

was supposed

to be ready for good work, that large additions to their buildings were necessary to reduce

In order to overcome this

the cost of maintenance to a defensible figure.

future, for projected institutions, a general block plan of the site should be

struction

is

This

started.

is

before con-

particularly true for public institutions depending for their

support upon the good will of the community which they are to serve, as in producing a symmetrical

difficulty in the

made

it will

greatly help

whole and avoid waste in maintaining the plant when completed.

In planning a new hospital or sanatorium the object should be to house the patients in a way that will provide as much comfort as possible. The size of the site and the block plan of the

grounds depend upon the number

the completed institution

is

of buildings to

be erected and the manner

in

which

to be administered.

Grounds For a sanatorium having a capacity open country, a

somewhat 20 ID 20 10 20

site

of

about one hundred patients situated in the

should consist of about two hundred acres of land, to be apportioned

in the following

manner.

40 acres for sanatorium buildings, amusements, park, forest and lake. farm buildings and the care of domestic animals. to 30 acres for a vegetable garden and potatoes. to 20 acres for an orchard and small fruits. to 30 acres for corn fodder. to

to 20 acres for

60 to 80 acres for pasture or grain. Usually a part of the drives, while roads

site

and cement

must be cleared and

laid out as a park,

or gravel paths with water mains beside

at suitable points are required near

and between the

buildings.

with walks and

them and

fire

plugs

For such improvements on

the grounds from $2,000 to $10,000 should be appropriated.

Railroad Station

Where

a site

institution should

tion

is

situated beside or near a railroad, or an interurban trolley system, the

have a

company may be

station,

and

in sparsely settled parts of the

willing to construct

it

for the sanatorium.

23

country the transporta-

The

building

may

be a

Section

I

one story frame or brick structure 15 feet wide by 30 feet long, divided into one large room ^ 2 feet wide by 1 5 feet long, and having at one end a cov1 5 by 1 5 feet, and two small rooms 7 ered freight shed 10 feet wide by 20 feet long. When the right-of-way is near the sanatorium buildings the station can be used to house the post-office, telephone exchange, express office

and a

store for the convenience of the patients

who

often wish to purchase material for

personal use. It

is

said to be an advantage to a transportation

sanatorium near

company may be

its

right-of-way and in

many

company

to obtain the location of a

sparsely settled sections of the country the

it

gives

employment

to local people;

Si.ooo to 81,500 per month, a part of which, at least,

is

it

expended

brings friends and visitors to nearby hotels, benefits the merchants,

produce raised

The sanatorium has a

willing to gi\'e the land for the institution's site.

great educational value;

has a pay-roll of from

in the

neighborhood;

and creates a market

it

for

in the vicinity.

Buildings and Improvements for Block Plan

The following is a when laying out

architect

list

of the buildings

the

site.

and improvements

to be considered

by the

Administration Building. Service Building. Patients' Pavilions. Amusement Pavilion. Power House (Heating, Lighting

Laundry and

Sterilizing

and Water-supply).

Room.

Industrial Shop. Ice-house or Cold Storage. Railroad Station, Post-office, and Telephone Exchange. Carpenter and Paint Shop. Store-house, Scale-house and Bakery. Green-house. Two hundred feet of Cold Frames or Forcing Beds. Vegetable Cellar. Garage. Barn for Horses.

Barn

for

Cows.

Silo.

Milk House. Colony Chicken Houses. Hog House. Sewage Disposal Plant. Sites for Hospitals to

The choosing of a

House Advanced Cases site

and the grouping

of the buildings of a hospital for far

cases usually presents an entirely different problem from that involved

sanatorium for incipient cases. in or

It is usually desirable to

advanced

when founding a

provide for the advanced patient

near the town from which he comes, and therefore the choice of a

site is largely

governed by the cost of the land and the attitude of the surrounding property owners.

A

hospital for this purpose should not be placed in a quarter where noise, the

from factories or the dust from uncared-for streets almost any

site is suitable

will affect the patients.

which can be easily reached, and is large enough to allow for the These questions are considered more in detail

construction of porches on the buildings. in

smoke

Otherwise,

Section III, Administration Buildings and Patients' Quarters Combined. 24

Site

and Grouping

EXAMPLES OF GROUPING AND The ings

and laying out

sites.

The Maryland State Sanatorium, is

SITES

following institutions are good examples of various methods of grouping build-

Sabillasville,

Md.

(Illustration 3.)

This

a well chosen site for a state institution, situated near the top of one of the mountains

Blue Ridge range, sixty-seven miles from Baltimore on the Western Maryland The sanatorium owns the station and has placed its power house on a siding

of the

Railroad.

The

close to the railroad in order to run coal cars directly over the storage bins. site is

building

reached from the power house and railroad station by a well graded macadamized

road twenty feet wide and a quarter of a mile long, which ascends gradually through a beautiful woodland.

The

buildings have been placed on a comparatively fiat piece of

land lying on the south side of the mountain, with a beautiful view of the valley.

Behind

them the ground rises for about four hundred yards, protecting the site from the north winds. At the top of this ridge is a concrete reservoir, having a capacity of seventy thousand gallons and supplied with water by pumps in the power house. The buildings are grouped together as shown in the illustration because of the topographical features of the land. The Administration Building stands in front and is connected by a corridor with the Service Building directly in its rear. The sleeping shacks are arranged in two rows on both sides and to the rear of the main buildings and the slope of the ground allows a good view of the valley and mountain from their porches which overcomes the objection of The capacity of the plant placing the front of one shack directly in the rear of another. is two hundred patients at an estimated cost of $150,000.

The Georgia State Sanatorium, of

Alto, Ga.

(Illustration 4.)

This

site is

a tract

land comprising two hundred and fifty-seven acres, located on the main line of the

Southern Railway, two miles from Alto and seventy-four miles southeast of Atlanta, with

The elevation is about sixteen a station about a quarter of a mile from the institution. hundred feet above sea level in a part of the country comparatively free from dust and where the air is said to be pure and invigorating the year round. The land has a general slope to the southeast and is fairly well protected on the north and west by a rising hill and

forest growth.

The problem for seventy-five

to be solved

by the

architects in arranging the block plan

was

to care

white patients at the present time and prepare for a future growth of the

four hundred white and colored charity cases of was adopted because of certain peculiarities in the contour of the land, which lies in the form of a horseshoe made by a flat with two promontories jutting out from it on the same level. Between the promontories is a ravine forming the main axis of the block plan. The Administration Building is located on the flat, directly at the head of the ravine at the north of all the patients' quarters, which are arranged on the two promontories. This plan worked out so well that one contour line runs institution to three

both

sexes.

hundred and

The plan

fifty or

illustrated

through seventy-five per cent, of the buildings, adding greatly to ease of administration, as

a level path will connect them.

Practically everything on the grounds can be

seen from the administration building, as the other structures were arranged with that idea in view.

Nearest the entrance to the west

is

the Reception Hospital, where

be housed for observation on their arrival. 25

To

the

left

and front

all

early cases will

of this

is

the library.

Section

I

M

ti V^

35c

Q <-2 a z g a ^

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^S| <

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26

Pi

-^

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Site

No.

and Grouping



4. Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Associated Architects. Block Plan Showing the Contour Lines and the Method of Grouping THE Lean-tos on Two Promontories in Front of the Administration Building. Note the Negro Quarters on the Left of the Illustration in the Foregrountd. Capacity to be 400 Patients. Estimated Cost, $175,000. (See illustrations 65 and 78 for further description of this

institution.)

To

the east or on the right of the illustration

administration building, and

still

east of this

is

the infirmary,

is

the dining

now

in use as a temporary-

room and the

service building.

In front of these main buildings on both slopes of the promontories are arranged the shacks for white patients (with floor plans adopted from the King type of lean-to at the

Loomis Sanatorium) twenty-four in all, having a capacity of ten patients each. Back of On the south and the main entrance drive near the road to the station are the stables. east of the service building but on a lower level is the women's work-shop, and back of the administration building are two cottages for the superintendent's family and physicians' residence. Still further to the rear and slightly to the east are a number of small cottages A service to be used as temporary quarters for the nurses or other members of the staff. building similar in plan to the infirmary for the white patients will serve the negro quarters

which are to be practically the same as those provided for the white patients, but entirely separated from them and concealed by a thick growth of trees and shrubbery. All the buildings are grouped

among

below these buildings the

pump

house.

in

This

hills,

well pro-

About

fifty feet

the pines on the southern slope of one of the

tected from the winds and with a pleasing outlook from the porches.

is a stream fed by a spring alongside of which is placed connected with an elevated tank for the storage of water, located

a ravine

is

There is a good supply of water, of the site to the rear of the stables. by constructing a dam, to furnish power for the institution. A farm and dairy are contemplated, for which there is ample land. This block plan is intended to show the institution as it will be when completed, and the estimated cost, including power plant, water supply and sewage disposal for four hundred patients, was $175,000, divided

on the highest point large enough,

among

the different buildings as follows: 27

Section

Library Recreation Building Superintendent's Cottage Doctors' Cottage Stable Negro Infirmary

$12,000

Administration Building Infirmary Reception Building Ser\-ice Building 32 shacks at Si, 800 each 2 work-shops, 84,000 each

I

15,000 15,000 15,000 5 7, 600 8, coo

$3,000 3,000 3,500 3,500 5,000 15,000

Waverly Hill Tuberculosis Sanatorium, Louisville, Ky. (Illustration 5.) The Waverly Hill site includes one hundred and seventy acres of land, situated on a range Park and overlooking the Ohio River and a magnificent stretch

of hills near Iroquois

of

country.

The

buildings are erected on concrete foundations with walls of frame construction,

covered on the outside with stucco, treated in bright and contrasting colors.

grouped closely

steep side of a

arranging

its

roofs

tile

alone in the foreground,

The

The

and the whole makes an interesting block of sanatorium buildings together. The administration building, which is two stories high, stands

are covered with red

its

hill in

position

side

and rear windows overlooking the patients' quarters.

the rear of the service building has been used to advantage in

and the

relation of the

power house

to the entire plant.

The

sana-

torium conducts a farm, dairy herd, and poultry in order to give the patients pure, fresh food and an opportunity for light exercise by work in the open plant

is

forty patients

and the

air.

The capacity

of the

cost $ioo,oco.

.WAVERLY MILL TUBERCULOSIS SANATORIUM

^^SMTOSE

No. 5.— Waverly Hill Sanatorium, Waverly Hill, Ky. J. J. Gaffney, Architect. Front Elevation AND BujcK Plan Showing Contour Lines and Method of Grouping Buildings on the Edge OF a Hill with a Steep Slope at the Rear. Note Back View of Plant, Illustration No. 18. Capacity, 40 Patients. Estimated Cost, Sioo,ooo. 28

Site

and Grouping

2

r.

'o

QPh A g

O Q <

<

Pi

o

2

o

^S

.du

Cfi

^

S o (A

c s bJO S o « I.

s

Section

I

Agnes Memorial Sanatorium, Denver, Colo. when

first

building.

The

lloor plans

The

feet

by

and a medical

pavilions are two stories high with porches

the entire structures on both floors.

3

This institution

were outlined by Dr. G. Walter Holden and adapted to the

Spanish style of architecture. II

(Illustration 6.)

constructed, consisted of an administration building, two pavilions

Every patient

is

around

housed in a separate bedroom

wide by 13 feet long, containing a radiator, a ventilating register and a closet These rooms open on to a central corridor at one end and at the other upon

5 feet.

a \-eranda space

1 1

feet 4 inches

curtains, in order to

make

wide by 8

feet deep.

the space private

when

raised to a height that will allow sunlight to penetrate into

the day.

It

off by sliding The roofs of the porches are each room at some time during

This can be curtained

desired.

has a capacity for forty patients, and cost $250,000, and was equipped for

§50,000 additional.

/^ot^eo j-too5£.

I? D/rr/rYO Hy\j.i,

^orti.ns ^AR.O

£)J-OCK. -PuA^n No.

7.-

Indiana State Hospital, Rockville, Ind.

^^^3A^^^^

Brcbaker and Stern, Architects. Bird's-eye View I lax. Showinc a Compact (iKoup of Buildings Ha\ing a Capacity of 100 Patients. Lost, 8137,000. (.Sec illustrations 26, 46 and 51 for further description of this institution.)

AND Block

30

Site

and Grouping

Indiana State Tuberculosis Hospital, Rockville, Ind. (Illustration 7.) This is a good example of a well chosen site and also of a method of grouping buildings The accompanying picture is a bird's-eye perspective of the hospital and closely together. institution

a portion of the grounds.

The land

cost the state $24,000 (approximately $50.00 per

of rolling, well- wooded land of which one hundred and twenty-five acres are along the creek bottom. The site lies on the east side of the Raccoon Valley about three miles east of Rockville, on a gravel road from Indianapolis. The hospital owns a free right-of-way for a railroad spur, of about one mile, to connect the property with the Central Indiana and the Vandalia Railroads, which run acre).

There are five hundred

There

through the valley. the railroads. blufT,

The

a station and a siding within one mile of the site on both of

buildings are located on high ground, slightly back from the edge of a

wath a beautiful view overlooking the valley.

for building

There

is

good, clean gravel and sand

purposes on the bottom land, clear soft water in large quantities in a creek at

the foot of the bluff, ton.

is

and four acres

The water

and good steam

for the institution

is

coal

which can be delivered on the

supplied

The plant has

of the highest degree of purity.

by

site at

$1.60 per

artesian wells in large quantities

and

is

a capacity of one hundred patients and cost

8137,000.

Portland Open Air Sanatorium, Portland, Ore. (Illustration 8.) The site of Open Air Sanatorium consists of eleven acres, six miles south of Portland on It is situated in a grove of evergreens, well a bluff three hundred feet above the river. sheltered from the winds, and is arranged to house all its patients in separate cottages These are arranged around two courts in front of the adminfor one or two persons each. the Portland

istration building.

This plan

is

particularly interesting to superintendents of institutions

housing only private cases, in a country having a mild, dry climate where dressing and

bathrooms do not need to be heated.

PORTLAND OPKN Alk zsssEniKiiMr

No. 8.— Portland Open Air Sanatorium, Portland, Ore. Whiddex & Lewis, Architects. Block Plan Showing Method of Groupixg Cottages about Open Courts and their Relation to the .Administration Buildings at a Private Sanatorium. Capacity, 40 Patients. Estimated Cost, S6o,ooo. (See illustrations 16 and 107 for further description of this institution.) 31

Section

I

VERMONT 5ANATOCIVM PITTiFORD

VT

-\BCHITECT^

women:* cottage

No. 9.—Vermont State Sanatorium, Pittsford, Vt. Scopes & Feustmaxx, Architects. View of Front Klexatiox and Bloik Plan. Showing Method of Grouping Pavilions in Front, .\nd AT THE Sides of the .\d.\iinistration Building. Capacity, 40 P.\tientp. Cost, $75,000.

Vermont State Sanatorium,

Pittsford, Vt.

(Illustration g.j

The

building site

and protected on

located on a practically flat piece of land with mountains on About three hundred feet to the south the north by a heavy growth of evergreen timber. ravine of the institution is a sharp drop in the land of over one hundred feet, making a the which in gravel and which there is a beautiful brook. The soil is a mii.xture of sand all sides

is

m

infiltration of

moisture

is

very rapid, and the water supply

is

procured from the Pittsford

waterworks. The patients are housed in individual rooms and the porches are constructed under the main roofs of the building rather than in the usual method. The administration building is planned with the infirmary in the second story and for an administrative capacity of from seventy-five to eighty patients.

The medical

offices are

placed in the

Site

and Grouping

west wing and as far from the service wing as possible, in order to avoid the noise from the kitchen. The cottages are designed with a capacity for twelve patients each, six

and are connected with the administration building by covered ways which are used by the staff in inclement weather and as extra sitting-out space for the

patients on a floor,

patients.

The

present capacity of the plant

is

forty patients

and

it

cost approximately

$75,000.

Essex County Tuberculosis Hospital, Soho, N. of buildings

quarters,

is

and

unusual, as the administration building

all

is

J.

(lUustration lo.)

are on the top of a small knoll with the land sloping rather abruptly

in every direction.

The

three buildings are connected

away by a covered passageway and the

pavilions have porches on the north as well as on the south side of the wards. of buildings

This group

placed in the rear of the patients

lighted from the central

This group

County Isolation Hospital, and is heated and power-house, which is on the same site. The pavilions are placed

was constructed

as a part of the

on brick piers and the administration building on a brick foundation,

all

constructed of

Jflfif* 'If--

HEESZESmUQH:

No.



10. Essex County Tuberculosis Hospital for Advanced Cases, Soho, N. J. Hurd & Sutton, Architects. View of Bcildixgs from the Rear and Oxe Side, and Block Plan Showing Method of Grouping Buildings on a Knoll antj Connecting Them by a Covered Passageway. Capacity, 84 Patient.s. Estim.ated Cost, $75,000. 3

3?>

Section

No.

I



Maine State Sanatorium, Hebron, Me. T. C. Stevens and J. H. Stevens, Architects. II. View and Block Plan Showing ^Method of Grouping Pavilions in the Rear of the Estimated Cost, Administration Building and Power House. Capacity, ioo Patients. $150,000.

(See illustrations 23

frame and covered

e.xternally

and 58

for further description of this institution.)

The capacity

with shingles.

is

for eighty-four

advanced

cases at an estimated cost of $75,000.

Maine

State Sanatorium, Hebron,

situated in the foot-hills of the

Me.

Falls Railroad, in a very beautiful country, well

The

site is

twenty

(Illustration 11.)

This institution

is

White Mountains two miles from the Portland and Rumford

known

for the

dryness of the atmosphere.

near the centre of the population of the state and consists of three hundred and

acres, of

which one hundred and twenty-five acres are farm land and one hundred and The buildings are well sheltered by a wooded mountain

thirty-five acres forest land.

with a fine open view to the south. There are many natural and logging camps with opportunities for winter sports, which stored in a rcser\-oir, with a capacity of

and are

The water supply comes from springs and forty thousand gallons, by a pumping station

an important consideration in holding them. is

features, such as forest land interest the patients

34

Site

and Grouping

pumps. The soil is a loam with a subsoil of gravel, having an and great fertility. Beside the administration building and pavilions, there is a power house, a cow-barn hghted by electricity and supplied with running water, having a capacity for twenty-five cows, a milk-house thoroughly equipped, heated by equipped with

electric

excellent drainage,

"'/*

^^^=f

^^if.r*'

No.

12.

W.

— Preventorium JuDELi.,

for Children, Farmingdale, N. J. Scopes & Feustmann, and Walter Associated ARciriTECTS. Bird's-eye View and Block Plan Showing Method (See illustrations 19, 27 and 95 for further description of this

OF Grouping the Buildings. institution.)

35

Section steam and supplied with

light

and power,

I

for the proper handling of

milk and cream, a

large silo with a capacity of fifteen acres of corn, a stable for ten horses

one hundred and

and

it

tons of hay.

fifty

The capacity

of the plant

is

and storage

for

one hundred patients

cost $150,000.

The Preventorium

for Children,

Farmingdale, N.

J.

(Illustration 12.)

present of about one hundred and fifty acres of land and

site consists at

rolling country.

The

is

The

situated in a

buildings are placed on a knoll seventy feet above the surrounding

and a growth of timber on the north, giving good protection from the winter winds. It is within six or seven miles of Lakewood, N. J., well known for its dry cHmate and sandy soil. The entrance is about four hundred feet to the west of the country road and all the buildings are grouped about sixty feet apart. The land, which has a gentle slope to the south,

dormitories containing the infirmaries are placed nearest to the administration building, described on page 145. buildings

and a small

There

is

a good sized creek within one thousand feet of the

river one-half mile

from the

The Central Railroad of New company has put in a siding one-

site.

Jersey crosses a corner of the property and the railroad

fourth mile from the power house without cost to the institution.

The water was driven

is

supplied from an artesian well four hundred and fifty feet deep, which

about seven hundred feet from the buildings, on lower land, and is by a small pump house in which is installed an electric pump driven by power generated in the central power house described on page 47. The water rises to within twelve feet of the surface and is conveyed to a wooden tank on a tower seventy-five feet at a point

co\'ered

high.

This institution was founded for the purpose of preventing children from becoming infected with tuberculosis

parents

who

who

are tuberculous.

live in

They

overcrowded parts

of

where the sickly children, through wise supervision, open-air usuall}-

New York

City and have

are sent from various clinics to the Preventorium

and pure, good food, are Only those children beand fourteen who are surrounded by tuberculous individuals and are life

completely restored to health in three or four months.

tween the ages

of six

without active tuberculous disease can be admitted to the institution.

The

shown have

cost, including

a capacity for one

hundred and twenty-eight

water supply and sewage disposal. Si 10,000.

36

children,

and

buildings

SECTION

II

Administration Buildings

SECTION

II

Administration Buildings

Methods

A

Sanatorium Administration

of

sanatorium consists

two

of

at least,

distinct parts,

necessary for the use of those

is

one for housing the patients and the

Therefore, some kind of a building, or a portion of one

other for administrative purposes.

who have

charge of the institution.

There are

three general plans of administering sanatoria for tuberculous patients.

The first method is to proxdde for this use a certain number of apartments in the same building that houses the patients. The second method (usually adopted at the present time) is to pro\dde a separate administration building and group lean-tos or cottages about it for accommodating the patients.

The

method (used only by large institutions of more than one hundred and and occupying a wide acreage) is to provide a general administration building near the centre of the site and di^'ide the patients' quarters into two or more units, each grouped about a small service building containing a kitchen, dining-room and other apartments needed, and placed at various convenient positions on the site. fifty

third

patients

Planning Administration Buildings In planning a sanatorium a good method to follow

is

to decide

upon the number and

character of buildings needed for administration and maintenance, then have these structures designed

structures

includes this

and constructed

In arranging

necessary. it

all

of substantial material

on

lines that

can be enlarged when

floor plans for the administration building

and

its

auxiliary

should be noted that the housing of the administrative department practically buildings on the

site,

department conveniently and

tion, the following questions

with the exception of the patients' quarters. in

To house

such a manner as will later tend to economical opera-

should be decided

if

possible before the working drawings are

begun. 1. 2.

3.

4. 5.

6.

The number of patients to be housed in the institution. The stage of the disease to be treated. The class in society from which the majority of patients will come. The number of the staff and the method in which they shall be housed. The number of servants and the method in which they shall be housed. the administrative ofhces and service department be housed under one two separate structures? Shall an amusement pavilion be constructed, or a large room for recreation purposes be provided, in the administration building? Shall an industrial shop be built for amusement and educational purposes? Shall

roof or in

7.

8.

38

Administration Buildings g.

10. 11.

12.

13. 14.

What method What method What method

water supply and storage shall be used? be used? of lighting shall be used? Will power be needed? Shall a power house be constructed? Shall a laundry and sterilizing room be housed in a separate building, the power of

of heating shall

house, or in the administration building? vacuum cleaning plant be installed? Can natural ice be used and an ice house be constructed or will a cold storage plant be needed? Shall the post-office, telephone exchange and store be housed in a separate structure or a room provided for these in the administration building? Shall a carpenter and paint shop be constructed or housed in the basement of the administration building? Shall a central store-house with platform scale and a bakery be constructed, or the basements of the various buildings used for storage and other purposes? Shall the institution provide its own vegetables and construct a greenhouse,

15. Shall a 16.

17. 18.

19. 20.

and a root

forcing beds

21. Shall the institution

cellar ?

conduct a farm and supply

its

own

milk, eggs

and dairy

products? 22. Will a sewage disposal plant be needed?

Number and

Class of Patients

The answers

to the first three questions in this list will largely govern the solving of

Therefore, the descriptions and estimates given here were obtained from public institutions having a capacity of about one hundred patients in various stages of the disease and coming from all classes of society.

all

the other problems.

Staff

and Servants' Housing The

following

list is

given in order to assist in planning a sanitary method of housing

the staff and servants at projected institutions.

which

this list

and are ready

was obtained

are low because

to accept smaller salaries

institutions, in order that they

may

The

many

salaries

paid at the sanatorium from

convalescent patients apply for positions

than are usually paid for the same service in other will tend to improve

remain in surroundings which

their physical condition.

Staff

and Servants and

their Salaries

Superintendent (Physician) Assistant Superintendent (Physician) Laboratory Director (Physician) Business Manager Bookkeeper and Clerk Stenographer

Matron Superintendent of Nurses' Training School Dietician

Ten Nurses

(each $180.00)

Three Orderlies (each $300.00) Postmaster and Storekeeper Chief

Two

Cook Cook's Assistants (each $240.00)

$2,500.00 per annum. 1,200.00 600.00 1,200.00 300.00 360.00 4S0.00 900.00 900.00 1,800.00 900.00 120.00 960.00 480.00

$12,700.00

Carried forward 39

Section II $12,700.00 per annum. 720.00 240.00 300.00 216.00 S64.00 1,296.00

Brought forward Chief Baker Baker's Assistant

Dish Washer Dish Washer's Assistant

Four Waitresses (each S216.00) Maids (each S216.00)

Six

goo. 00

Chief Engineer Engineer's Assistant

Fireman Caqienter andiPainter Gardener, in charge of Greenhouse and Grounds Two Garden Helpers (each S360.00) Poultry Man Three Farm Hands (each S360.00)

.

.

.

480.00 360.00 600.00 720.00 720.00 600.00 1,080.00

Total

821,796.00

Note: This makes

As has been

a pay-roll of

"

"

S1S16.00 per month.

and servants may be incipient, conemployment of this class will matericareful hygienic and sanitary housing

said a large proportion of the staff

valescent or cured tuberculous patients and while the ally reduce the size of the pay-roll

it

will also call for

with provisions for outdoor sleeping.

The upper used in nurses'

many

stories of the administration building Avhen pro\'ided

with porches, are

institutions for this purpose, although the construction of a

home, and a servants' pavilion

is

a better

method

of

staff'

cottage, a

housing them.

No. 13.— Adirondack Cottage Sanitarium, Saranac Lake, N. Y. The Amusemext Pavilion. \'IK\VS OF THE KXTEKKJK AND INTERIOR WITH FlOOR Pi.AX AND CrOSS SeCTION. fSee illustrations 63, 98, 104

and 109

for further description of this institution.)

40

Administration Buildings

^L

II

No.

*



14. Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Hermann M. Biggs. James D. Burt, Architect. Servants' Building No. 107. This Structure is an Example of a Lean-to Constructed with Fire-proof Material, Designed to Supply Open-air Sleeping Quarters FOR Servants who wish to Remain and Support Themselves at the Institution after Completing the Treatment. Capacity, 16 Persons; Cost, ^5,000.

Municipal Sanatorium, tion 14.)

This

is

Otisville,

N. Y.

The Servants'

Building.

(Illustra-

The walls are on both sides. The copings

a two-story building, with a foundation of native stone.

burned hard, and plastered moulded on both edges, and reinforced with w-aste wire. The outside is finished with wood float in sand, and coated with a water-proof paint. The inside is finished with plaster and painted with ordinary white lead and linseed oil. of eight-inch hollow terra cotta

on the parapet walls are

tile,

of cast concrete,

Each person has an individual

dressing room, about five feet square,

made with

and furnished with a chair, table, mirror, shelf, and hooks for clothing. The sleeping porches are divided by low, transverse This practically makes of partitions running from the rear wall part way across the floor. low partitions in order to allow a free circulation of

air,

the porches small rooms, sufficiently deep to allow space for an easy chair inside the open

Both

and the porch floors have a pitch of three inches in order and wash water to an outlet. There is a slop sink on each floor, an iron fire escape on the walls of both wings, and an attic covering the centre of the building. The basement contains a heating apparatus, two toilets, and baths. The building accommodates sixteen persons, and cost exclusive of plumbing and

front.

stories are alike

to drain storm

heating, about $5,000. 41

Section II Service Buildings

There

is

:i

growing feeling among the superintendents

of

many

sanatoria that the

method of housing the dining room and kitchen, is to construct a separate service The principal ad\'antage of this method of construction is in isolating from other building. departments the preparation of food, and in giving greater opportunity to build an open It is also a much more economical way of building if an institution is to air dining room. best

be started to enlarge

way on lines which can be enlarged as it grows, for it is an easy matter an administration building by constructing a service building nearby. For

in a small

these reasons a

number

of large

and small

service buildings are described

and

illustrated in

this section.

Amusement If

Pavilion

good

results are to

be expected from the open

air

treatment of tuberculosis, the

Worry and depression are and anything that helps to do away with them is a part of the cure. patients often sit about a hospital or sanatorium day after day, brooding

question of making the patients contented must be considered. large factors in disease

Certain classes of

over their troubles and discussing retards recovery.

If

among themselves

their physical condition,

which often

such patients are kept interested in other things they will have

less

time to think about themselves, and, therefore, amusements and interesting occupations

When possible, a separate amusement pavilion should be constructed. room placed in the administration building is not satisfactory, as it is very hard to ventilate, and patients taking the open air treatment are often oppressed by remaining indoors, and refuse to use such rooms. A separate structure for an institution of one hundred patients should be about seventy-five feet long by thirty feet wide, with a peaked roof. The building can be constructed of tile, brick, concrete or frame and the roof supported by trusses and covered with shingles or some patent roofing material. The main room should be open to the roof about tw^enty-three feet from the floor to the peak. should be provided.

A

recreation

No. 15.— Example of a Dining

Room

in a

Separate Structure Which can be Opened on All Sides. 4^

Administration Buildings

No.

A

-Portland Open Air Sanatorium, Portland, Ore. View of the Interior of the Amusement Pavilion. (See illustrations 8 and 107 for further description of this institution.)

i6.

by fifteen feet wide, with a room on either side for dressing and other purposes. The building in northern climates must be heated, either from the central power house or by a small heating plant placed in a cellar under the main floor. Both sides and the end opposite the stage, except for the supporting columns, should be entirely constructed of adjustable windows or doors, so that the side of the building exposed to a wind or storm can be closed and the opposite side remain open. There should also be large ventilators in the peak of the roof and on the sides and ends of the building. (See Illustrations Nos. 13 and 16.) stage can be placed at one end of this room, twelve feet deep

small

Industrial Building

The same arguments which ment

pavilion, hold

good

are used in advising a separate structure for

in regard to

an industrial shop.

an amuse-

This building can be constructed

along the same general lines and of the same material as the amusement pavilion, the dimensions being about fifty feet long

by

thirty feet wide, one

and one-half

stories high,

and with

both sides enclosed by glass doors or windows that can be entirely open when the weather permits. It should also be heated by connection with the general heating SA'-stem or by a separate plant of

its

own and equipped with

tools

used in various industries, such as light

work and photography. If the building is rooms, porches should be added so that the patients can work out

carpentering, cabinet making, taxidermy, art

divided into a of doors in

number

of

good weather.

In every institution there are always patients

who

will

be greatly

by attending school and are glad of an opportunity to do so. As there is often a teacher among the patients, who is willing to teach, space for a school-room, if

benefited school

needed, should be provided for in this building.

paper

Part of the outfit can be a machine for stamping out sputum cups, for is

supplied for this purpose,

all

the cups used at the sanatorium can be

if

suitable

made by

the

patients.

The

cost of such a building

to start in a

more modest way

and equipment

is

about $4,000, but

it

may

be advisable

in order to test the interest of the patients in various

occupations. 43

Section II

Water Supply Where

there can be no connection

with city or other pubKc water mains, the

water supply for an institution tained in a

number of ways and

may all

sources should be carefully studied.

may be

be ob-

available

There

sources which can be examined with-

out great expense, such as old wells, springs, brooks, rivers, ponds and lakes, or sources

which can only be accurately determined by experiments which are often quite costly, such as the driving of various kinds of wells No.

17.

— Catawba

and the building

Catawba, Va.

Sanatorium,

Ax Example of a Good Method of Storixg Water Where Streams can be Protected (See illustrations 30, 69, for further description of this institu-

for the collection

Wells are often the only means by

tion.)

which water can be obtained, but shallow or dug wells should not be used, as the dan-

ger of contamination three hundred or tional use

dams

water.

FROM Coxtamixatiox. and 80

of

of surface or other intermittent supplies of

is

more

and the

very great. feet, to

Driven or bored wells carried deep enough, usually

avoid surface water, should always be sunk for institu-

site carefully selected

with the \dew of preventing contamination of the

Often where from thirty to fifty thousand gallons per day are needed more than one well must be driven in order to produce a sufficient supply. The cost of driving varies from v^3.oo to ^^S.oo per foot, according to the size of the bore water when

it

reaches the surface.

and the depth to which the well is carried. In making investigations of a w^ater supply, great care should be used

to obtain

information in regard to the chances of contamination of the source of the water, the

chemical elements held in solution, and the amount of the flow at

all

seasons of the year.

In order to decide w^hether a given source will supply the demand, an estimate of the daily

Although it is a very inaccuconsumed in every twentyfour hours by each individual housed on the site, about one hundred gallons, by each horse or cow fifty gallons and for every acre of lawn, streets, paths, or garden five hundred gallons, and the estimate is intended to cover all water used for drinking, cooking, toilet, sprinkling and other necessities. consumption

of the

rate method, this

A careful sites

with

to fifty

staff,

is

proposed institution should be computed.

usually done on the theory that there will be

inquiry has shown that institutions of one hundred patients having large

servants and animals, and carrying on a farm,, will use from twenty

thousand gallons of water per day and should when possible have in reserve for

emergencies, an

amount

at least equal to the daily consumption.

should be stored, depends upon the nature of the constructing reservoirs.

For

this reason

about the limit where the cost

is

great,

from

site,

fifty

but where natural basins can be used by erecting

a small dam, larger quantities can be held for a small outlay. inforced concrete reservoir

is

The amount which

which largely governs the expense of to two hundred thousand gallons is

the most satisfactory

if

there

The is

storage of water in a re-

a natural elevation near the

buildings.

Reservoirs can usually be placed in the most convenient position available with-

out fear of obtaining too great a pressure in the mains, as the force produced by water brought from a height is greatly reduced by the friction in the pipes. Where there are no 44

Administration Buildings natural elevations, water can be distributed through an institution and a moderate stored

by tanks on towers,

by small towns

or in the top of the buildings.

amount

Also by stand pipes, largely used

middle west, which give good service and can be adopted for the and the various systems of water supply using a pressure tank for small

in the

larger institutions,

sanatoria.

Light,

Heat and Power The problem

of lighting, heating,

depends largely upon

its

advanced cases situated trunk

line of

in

cities

and the

installation of

power

for

an institution

Generally the furnishing of light for hospitals for

situation.

and

their

suburbs

is

not a

difficult

matter, as the

the city electric lighting system or the mains for illuminating gas are

usually not far distant.

The lighting of lies

sanatoria in isolated country districts of kerosene oil lamps,

between the use

is

more complicated and a choice

one of the various processes for generating

by individual gas machines from oil, gasolene or acetylene, or electricity produced by a privately owned plant. At the present time electricity is generally used, and when installed in an institution having a capacity of one hundred patients housed in various structures, it is estimated that about live hundred and fifty, sixteen candle power and one

illuminating gas

hundred and

fifty,

two or four candle power lamps

for the buildings, six

one hundred

candle power arc lights for the grounds, two six thousand candle power generators and two fifty

horse power engines will be needed, the lamps being apportioned as follows

Administration Building

154 lights 150 183 66

Two Advanced

Case Pavilions Three Incipient Case Pavilions Nurses' Quarters Amusement Pavilion

50

Laundry Power House Tunnel Grounds

15 •

15

20 6 arc lights

Four candle power

lights

can be used to good advantage in

many

places, such as

and are a great saving, as every candle power needlessly used in the course of a year means a waste of fuel. In heating sanatorium buildings practically every method has been tried and can These still be found giving fairly good service at one or another of the various institutions. in a general way are steam and hot water plants, hot air furnaces, stoves, fire-places and hall-ways, closets, toilets and porches,

Here again the location and climate are largely the determining factors in making a choice of a method of heating, particularly where the buildings of an institution

gas fixtures.

are heated as separate units.

Power can be used

for lighting,

pumping, vacuum cleaning, driving laundry ma-

chinery, a cold storage plant, elevators, .T-ray apparatus, laboratory instruments, lathes, circular

saws and other machinery in carpenter and repair shops.

Power House In discussing the needs for in

producing them,

it

light,

heat and power, and the methods to be employed

should be remembered that 45

it is

possible where a central plant

is

to

Section II

No. i8.—Waverly Hill Sanatorium, Waverly Hill, Ky. J. J. Gaffney. Architect. View from the Rear Showing a :\Iethod of Using the Top and Side of a Hill in Order to Obtain a Position Below the Buildings for the Power Plant. (See illustration 5 for further description of this institution.)

be assembled to house

it

either in the

basement

of

one of the buildings or in a power house

but there seems to be a strong feehng against installing it in the basement of any sanatorium or hospital building, as the heat from the boilers is very

especially constructed for

it;

and dust penetrate to other parts of the structure. If the institution grows the time is sure to come when it will have to be removed, and therefore it is advisable to house even a very small plant in an isolated power house when starting an disagreeable and the noise

This should be placed below the

institution.

site of all

buildings to be heated, in order to

allow the return by gravity, of condensed steam or hot water from the heating apparatus, and if this is impossible where the land is fiat, a pit must be dug under the plant for this

purpose.

In choosing a

site

the question of placing the building beside a siding or spur from

a railroad should be considered, for such a position will greatly reduce the expense of handling coal

and

ashes.

The administration and

all

other buildings to be heated, should be

them by a concrete or brick and expense will be saved if the

grouped near enough to the power house to allow connecting tunnel three feet wide

by

six feet high, as

much

trouble

pipes and wires connecting the buildings can be inspected through their

full

length at

all

times.

The

building should be of brick or reinforced concrete construction, one story high

and divided into an engine room, boiler room, oil room and dressing room, containing toilets and shower baths. The coal bins should also be of concrete having a capacity of six or eight carloads, placed on the outside of the building, and arranged, if possible, so that the coal can be dumped directly into them from the cars. In equipping various power houses the question of installing low for high pressure boilers and substituting gasolene or oil for steam engines, in producing heat and power, has been carefully investigated.

and architects having

It

now seems

to be the consensus of opinion

pressure boilers with steam engines

is

among

engineers

power plants, that the use of high the cheapest method, at the present time, of produc-

large experience with isolated

46

Administration Buildings and power for public institutions when the exhaust steam is used is adopted the equipment for the power house should consist of:

ing light, heat If this

method

Two Steam

One Coal Truck and Track One Open Feed Water Heater Two Water Pumps One Fire Pump

Boilers of loo H. P. each for Service Hot

One Water Tank Water

Two Steam Engines Two Electric Generators

Two

Mechanical Stokers

One Set of Machinist's Tools One Power Drill and Lathe

One Storage Battery One Oil Separator The

for heating

building with equipment will cost about Si 5, coo.

EXAMPLE OF POWER HOUSE The Preventorium tration 19).

are of hollow

This tile

for Children, Farmingdale, N. J.,

Power House

(Illus-

a two story building, 59 feet wide by 43 feet deep. The first story walls with reinforced concrete construction, and fireproof partitions of hollow is

There are two complete power units, each consisting of a high pressure horizontal tubular boiler, a steam turbine directly connected with an electric generator and a switchboard. There is also an ice-making machine, a large scale for weighing fuel and a hot water storage tank. The second floor houses the laundry and has partitions of frame, covered with wooden lath and plaster. It is divided into a receiving and sterilizing room tile.

No. 19.— Preventorium for Children, Farmingdale, N. J. Scopes & Feustmann, and Walter W. JuDELL, Associated Architects. Power House and Laundry. Front and Side Elevations WITH First and Second Floor Plans. (See illustrations 12, 27 and 95 for further description of this institution.)

47

Section II

No.

—District

Tuberculosis Hospital, Lima, Ohio. McLaughlin & Hulskin, Architects. of the Basement Floor Plan, Showing Arrangement of Laundry and Power Plant, (See illustration 43 for further description of this institution.) IN an .\dmixistration Building. 20.

A Part

equipped with a pressure steam sterilizer, a general laundry room containing metal washers, an extractor, mangles and steam pressure pumps and electric motors for running the machinery, an ironing room equipped with electric irons, a distributing room, and a room over the ice-machine from W'hich ice is distributed to the small refrigerators in the various buildings.

The and

is

third or attic floor

is

divided into four large rooms and bath for the male help,

reached by a separate stairway w^hich does not open on to the laundry

The

floor.

building cost $9,000 and the mechanical equipment of the institution, including

water supply and sewage disposal, cost $32,000.

The Laundry The laundry should be housed long,

and one and one-half

crete or brick, or

should

Ije

it

open to the peak and constructed

can be placed in the power house and

made

wdde by

fifty feet

of reinforced con-

a part of that building.

It

divided into four rooms for receiving the soiled clothes, washing, ironing and sorting.

Laundries placed

in the

proper ventilation

on the

in a separate building, thirty feet

stories high,

is

basements

impossible.

interior, plastered

of administration buildings

The

have been unsatisfactory, as

building should have a cement floor

with hard plaster and painted.

and

if

finished

The hot water and steam

as well

power for driving the machinery can be supplied from the power house and the equipment should consist of as the

Two Washers

One Tank

One

Two

Centrifugal Wringer

Two Mangles Two Drying Racks

for

Mixing Soap with Steam

Sets of Irons

One

Set of Sorters' Shelves Six Tables

In some districts a cistern for storing rain water will be needed.

The

entire plant including

the cistern can be constructed and equipped for from $6,000 to $10,000.

Administration Buildings

Room

Sterilizing

Connected with the laundry there should be a sterilizing room about ten feet wide by twenty feet long, constructed of concrete with a cement floor and equipped with a rectangular steam disinfecting chamber, thirty inches wide, fifty inches high and eighty-

This chamber

usually built with an inner and outer shell of steel plates and closed by doors at both ends hung from davit cranes. They are also equipped with a wrought iron car, an inside and outside car truck, two cast iron supports, a thermometer, steam pressure gauge, vacuum and pressure gauge and two safety valves. With an instrument of this size, beds, bedding, linen and clothes needing The room and sterilizer in connection with the laundry, if disinfecting can be sterilized. placed near the power house, can be constructed and installed for about $1,500. (See Illusfour inches long.

is

securely ri^eted to the end frames

tration 21.)

Vacuum Cleaning

Plant

This method of cleaning sanatoria and hospitals that from an economical point of view

per cent of the cost of cleaning, that

fifty

plaster,

pay

it will

have

is it

becoming popular. installed,

also reduces to a

it

wood-work, decorations and other

to

and

will

It is said

save in labor

minimum the wear on By this method

finish of the buildings.

paint, clean-

up the dust and dirt, and Avaste of all kinds which cannot be reached by the ordinary means, is easily removed from corners, nooks and cracks. The usual plant installed for institutions is operated by electricity obtained from the generator, which supplies the current for lighting. The power necessary is about one hundred and ten volts, but when it is not available the plant can be operated by a two cylinder ten horse power gasolene engine. The vacuum cleaning machine itself is placed in the power house or basement of the administration building, and consists of a reciprocating pump, with a motor on the same frame, and a separator. It is connected with all the buildings by a main trunk line pipe, gi\dng off vertical pipes ending in service inlets at convenient points where a hose can be attached for the cleaners. These inlets are usually placed in the walls of the corridors near the floor but can be installed at any point desired. The hose which connects them with the cleaner can be fifty feet long, if desired, and the intakes located at points where a circle of fifty feet from them will reach every place to be cleaned. The dust and dirt is conveyed from the apartment being cleaned, through the hose, vertical lines, and trunk lines, to the separator, where about ninety-eight per cent of the dirt is taken out of the air drawn into the pipes. The balance, or two per cent of the dust and dirt, passes through the machine and out of an exhaust pipe which discharges into a flue or other convenient place to reach ing can be done without stirring

the open

A vacuum

air.

plant suitable for a sanatorium while cleaning an apartment re-

moves about two hundred and through open windows by pure, chine

is

forty cubic feet of air per minute. fresh air, the

rooms

will

If this is replaced

be well ventilated while the ma-

in use.

The pump and

separator will cost $1,500, the piping and installation of the plant

about $1,000 more, making a total cost

of the plant of $2,500.

Three complete

sets of

sweepers and tools are supplied with the machine and extra sets consisting of a floor sweeper, floor brush,

Ice

renovator and tufter cost $75.00.

House Ice

is

or Cold Storage Plant

an absolute necessity

manufacturing or storing 4

it

must be

in a hospital or

supplied. 49

The

sanatorium; therefore, some means of construction of an ice-house

is

a simple

Section II

No.

— A Rectangular Steam Disinfecting Chamber, for Use in Connection with the Laundry. A CoxvENiEXT Shape for Tuberculosis Hospital axd Sanatorium \\'ork. Loaned BY The Kny-Sheerer Company.

21.

matter

for a small institution,

natural ice can be obtained on or near the

if

installing of a refrigerating plant is usually cheaper for large institutions

and

filling of

an

ice house.

If a cold storage

plant

is

constructed

it

site,

but the

than the building

should be placed in the

administration building or store house and arranged to provide coils for the various refrigerators.

The

from

cost will be

Si, 800 to 8,3.000.

The Carpenter and Paint Shop A repair shop may be combined structed as a separate building.

It

with one of the barns, the industrial shop, or con-

should be about ninety feet long by twenty feet wide,

constructed of frame, brick, or concrete, one story high, with peaked roof and an air space

above the storage

ceiling.

room

It

can be di\-ided into a carpenter's room, paint room, store-room and

drying lumber; and equipped with a circular power saw, necessary carpenter and cabinet-makers' tools, and a painter's outfit. The man in charge should be a good for

practical cabinet-maker able to repair furniture

have a painter as one of

his assistants.

of the entire institution

and

to build

and equip

will well

and the woodwork

of the buildings,

and

This department has a large share in the up-keep

repay the investment of 81,500 to 82,000 necessary

it.

The Store House, Bakery and Scale House

A

large

amount

of storage space

is

a necessity in a sanatorium or hospital.

Gro-

and other winter food supplies, furnishings, hnens, clothes, and the farm or grounds must be bought in bulk or numbers, in order to obtain

ceries, grains, vegetables

many

things for

At many institutions, portions of the basements and cellars of the various buildings are used as storage rooms, but this is a wasteful and inconvenient method of fair prices.

administration and .should be abandoned. Buildings are more sanitary when rightly constructed without arrangements for storage purposes, but with low foundations and cellars

having a good circulation of manner.

air,

so there

is

50

no good reason

for

housing stores in this

Administration Buildings It has

been tried and found very satisfactory, as well as a great help

in reducing

expenses, to have a separate store house under the care of an employee who gives his time to

and distributing supplies. At all large institutions the bakery should be separate from the kitchen. In a number of instances it has been placed in the basement of administration buildings, but this is not satisfactory, as it requires the baker and his assistants to work in a room that is hot and hard to ventilate. A small separate structure connected with the general store house or as a part of it, should be built for this purpose; the bake room to be about twelve by fifteen feet with the oven constructed outside the walls. In connection with the store house and bakery there should be a platform scale. The weighing room may be a separate, small frame building, or a part of the store house, with the scale platform on the outside, arranged so that trucks and wagons can conveniThe scale will cost about S80.00. There is no doubt that the sa\ing ently be run over it. made by a careful oversight and concentration of the stores and the weighing of the grain and other supplies bought in bulk, will soon pay for the construction of a store house. A bakery and store house equipped with a scale can be built for from $1,200 to $2,000. the details of ordering

Green House, Forcing Beds and Vegetable Cellar

A green house for

and flowers can be placed near the power house, and the forcing beds, a supply of fresh lettuce, radishes, onions, rhubarb, spinach, parsley, turnips and other green vegetables may be produced during the entire winter. This building should ha\e in connection with it, about 200 feet of cold frame or glass forcing beds, and a root or vegetable cellar constructed of concrete, half above and half below ground level, with bins and divisions, of the same material. A root cellar is a need which is generally put off, with the idea of using the basements of the building for this purpose, but because of the pipes and mains from the heating plant, basements often cannot be used. The expense of building a green house, frames and root cellar will be about 85,000. vegetables, plants

and by using the surplus steam

for heating

it

Garage, Barn, Stable and Farm Outfit It is

necessary to have a stable for farm, carriage and riding horses, in conjunction

with a barn for housing saddles, harness, carriages, wagons, machinery and garage for motors when institutions are located in more or concrete,

and may,

paint shops.

A

if

desired,

it

and a

tile,

or reinforced

under one roof the industrial, carpenter and

barn can be erected for from 85,000 to Sio,ooo, depending upon the size The following list obtained from a state sanatorium, is a partial

finish of the building.

outfit of

farm

tools

and machinery, which

Two Farm Wagons One Delivery Wagon One Wagon Scale

will

be needed

Sulky Plow Ordinary Plow

One One One One One One One

Harrow

Two

Two Double One One One One One One

combine with

tools,

secluded sections of the

This building can be constructed of frame, brick, concrete,

country.

and

less

Sets of Harness Single Set of Harness

Mowing Machine Side Deliverv

Rake

if

a farm

is

a part of the institution.

Potato Planter Potato Digger

Corn Planter Corn Binder Power Feed Mill Power Hay Cutter

Hand

Cart Two-horse Cultivators One One-horse Cultivator One Fanning Mill

Section II

One Feed Cooker for Garbage One Potato Sprayer

One Hay Loader

Hay Slings One Hay Carrier and Rope Two Hay Racks One Horse Lawn Mowing Machine One Horse Lawn Roller One Meadow Seeder Six

Two Scythes Two Corn Shredders One

Set of Garden Tools Shovels

Spades Other Small Farm Implements

One Manure Separator

The Cow Barn

i

down the cost of maintaining an institution is through ownSome institutions have shown that the purchase butter. and ing cows and producing milk amount necessary to produce it on the site. double the costs of milk from outside sources hundred patients will consume the milk from one for institution It is estimated that an One method

of

keeping

thirty-tive cows, as one-fourth of the herd

is

usually dry.

A cow-barn should be kept clean and the animals made comfortable. This is most easilv done if the floor is of concrete, well drained and the building arranged to admit plentv of light and air. The cows should be held by movable stanchions, facing each other on either side of a feeding alley in the centre of the building. Such a barn may be constructed of reinforced concrete, tile, bricks, or wood, the dimensions about thirty-six feet wide by eighty-six feet long, one story high, with side walls seven feet

six inches

The

high and nine feet clear at the centre.

roof can be supported

by

trusses and covered with shingles or composition roofing, the interior sealed with smooth painted tongued and grooved boards or plastered over metal lath. The concrete floor out^ht to be

slight grade,

on a

drained at one end, and by gutters in the manure alleys four-

The

ventilation should be carried out through a

teen inches wide

by

double system of

air spaces in the walls, following the

lation

by means

six inches deep.

of the

nine feet wide, the

manure

sections seven feet wide. different sliced

alleys four

King method of heating and ventiby the cows. The central feeding alley should be feet wide, and the cross alley dividing the stalls into

The

should be three feet wide, with a graded depth for

heat given

cows of from four

off

stalls

feet eight inches to five feet,

and constructed

of iron piping,

with chain hung stanchions. The mangers can be made of concrete in the form of a long trough for each section, having a slight fall toward one end so that they can be washed, flooded with water and drained.

fitted

The

Silo

A

silo is

a tank in which fodder in the green state

is

preserved.

It is usually

round

and can be built of reinforced concrete, brick, concrete tile or wood and is considered one of the best and cheapest buildings for storing and handling fodder for feeding a herd of milch cows. A silo large enough to store fodder to feed a herd of thirty-five cows for six months should have a capacity of one hundred and twenty-six tons, a diameter of fifteen feet, a height of thirty-four feet, and will require about eight and one-half acres of land planted with corn to

fill it.

fodder, which

It should be placed beside the is

heavy, can be handled

cow barn

in a

convenient position so that the

easily.

The Milk House

A

milk house should be arranged to concentrate the work of the milkers and care

for the milk

by the best methods.

Hot water and steam 52

will

be needed and can be piped

Administration Buildings from the power house or supplied by a small vertical boiler installed in the building. A wash room for the milkers should be placed so it can be entered without passing through

Such

the other parts of the milk house.

one

feet

interior,

wide by twenty-two

feet long,

a building constructed of

frame or

one story high, with peaked

with round corners, and cement

floors, will

tile,

twenty-

roof, plastered

be found convenient.

It

may

on the be

di-

vided into four rooms ten feet high in the clear, and connected with the barn by an enclosed

The weighing room

covered passageway seven feet wide.

is

by

eight feet wide

eight feet

deep and contains a desk for records, a scale for weighing each milking, and a platform under a mo^able funnel for conveying the milk to the cooler in the adjoining room. The bottling

room i? eight feet wide by twelve feet long, equipped with a cooler, bottler, and a refrigerator. The utensil wash room is twelve feet wide by thirteen feet long, fitted with hot and cold water faucets, two large sinks, a sun rack and a utensil

sterilizer built into the wall so that

from the wash room can be removed

in the bottling room beside the The milkers' wash and locker room is eight feet wide by thirteen feet containing two hand wash basins, running hot and cold water, and four iron lockers for

the bottles placed in

it

spout of the cooler. long,

towels and milkers' clothes.

The capacity milk house,

silo,

of the barn is thirty-five cows and the plant complete, including barn, and a cow shed, can be constructed of concrete tile for from $5,000 to

Sio.ooo.

Chicken and Hog Houses Chickens and hogs are also a part of the equipment of

many

It is said

sanatoria.

that fifteen hundred to two thousand hens will supply chickens and eggs through the entire

year for an institution of one hundred patients

if the surplus of eggs produced in the spring and summer are preserved in lime or by cold storage. An outfit including chickens, colony houses, incubators and other equipment costs about $3,000. There is enough refuse from the tables of large institutions to feed twenty-five hogs and the annual income from this number at one sanatorium is about four hundred dollars

In order to make these animals profitable a healthy herd

a year. care

must be used

to eliminate those with disease

steam cooker should be installed and

possibility of infection later a

feeding passed through

it.

is

A

necessary; therefore,

To prevent

when purchasing them. all

the

table refuse used for

sanitary hog house with a wire screened run can be built for

$1,000.

Sewage Disposal Plant

A

hospital or sanatorium which

nection with

its

sewer system

will

is

disposal to be installed depending largely

a farm

is

upon the

site

obtained for the institution.

Where

part of the property the simplest methods can be used, such as a septic tank with a

subsoil distributing field.

people

not situated close enough to some town for con-

need a sewage disposal plant, the method of sewage

may

A

small disposal plant of this kind to serve a limited

consist only of a septic tank about

twenty

feet

by twenty

feet

and

number

of

six feet deep,

divided into two compartments and distributing the sewage at intervals to the subsoil of a level cultivated field

by open jointed

inches from the surface.

The

agricultural drain

tiles, laid

at a depth of about ten

disposal field should be divided into sections,

and the sewage

discharged into one section after another, allowing enough time to intervene after the use of each

one before

it is

used again for the absorption of the entire discharge.

that from one to three feet of drain

tile

according to the nature of the

gallon of sewage. 53

soil will

It is

estimated

dispose of one

Section II

Where

the site of a large sanatorium

below the buildings,

filter

beds must be

is

small or a running stream or lake

used in connection

is

near and

with the septic tanks.

The

effluent of the septic tanks is then passed through siphons, which intermittently discharge a Usually two or more part of the contents of the tank evenly over the surface of a filter. filters

are used, the sewage being deposited

upon one

after another automatically.

Differ-

and numerous varieties coke and other material

ent conditions require a variation of methods in sewage purification of filters

Sand, gravel, broken stone, clinker,

have been devised.

are used with success, the object being to expose the contents of the septic tank to the air and the action of bacteria, and in this manner purify the sewage as it passes through the

and before it is allowed to flow away. It is estimated that a septic tank of the dimenabove and two sand filters twenty-five by one hundred feet in area and four deep each, will purify the sewage from about three hundred people and will cost from

filter

sions gi\-en feet

Si, coo to 8,1,000.

EXAMPLES OF ADMINISTRATION BUILDINGS Eudowood Sanatorium, Towson,Md., Admixistration Building 22).

(Illustration

This building was rebuilt and greatly enlarged in igoS, only a part of the old building

havang been retained as a nucleus, and even central portion

was

five feet deep, of

this

was

originally a country residence.

entirely rearranged.

It

is

The main or by thirty-

forty-eight feet wide

frame construction, externally covered wdth shingles, two stories with a

high basement and a third or attic story under the roof supplied with light by dormer

windows.

The foundation

is

of native stone carried well

order to give light and air to the basement.

There

is

up above the ground

level in

a porch twelve feet wide across the

and second stories and the interior on the first floor is divided in the by a broad hall twelve feet wide. An office 15 feet wide by 15 feet deep, and a library 12 feet wide by 15 feet deep, are on one side of the hall, and on the other a physician's office 8 feet wide by 17 feet deep, an examination room 7 feet mde by 12 feet deep and a staff dining room 12 feet wide by 17 feet deep. The second story is arranged into two separate apartments, one, of two large rooms and bath for the su[)erintendent, and the other, of three small rooms and bath, for the matron. The third story is divided into four chambers and a bath for the nurses. The new additions consisted of two large wings and a rear extension. The side wings are both 24 feet wide by 52 feet long, connected to the sides of the main building by passageways fourteen feet long, making the entire front one hundred and eighty-three feet long. The rear extension is sixty-eight feet long, also joined to the main structure by a covered corridor. The wing to the right of the building consists of one large room 23 feet deep by entire front of the first

centre from front to rear

50 feet long, with a ten foot porch on the front given up to amusement purposes. The wing is an infirmary, divided into two small wards 20 feet wide by iS feet deep, for four

to the left

bed- each, with

The feel

toilets

and baths, and a porch

in front ten feet wide.

room 54 feet wide by 35 and containing a large open

rear extension contains a spacious well lighted dining

deep, having a seating capacity

Behind

room

of

sixty

patients

same extension is a kitchen 24 feet wide by 18 feet room and storage. The rear extension was built so as to allow the patients to enter the dining room at the rear of the administrative offices, thus avoiding the tracking of dirt and mud through the main building, and in order to cut off the noise usually made by a large number of people fireplace.

this

in

the

deef), a servants' dining room, pantry, sewing

54

Administration Buildings

No. 22.

— Eudowood

Sanatorium, Towson, Md. Archer & Allen, Architects. The AdministraInfirmary and Service Buildings. View of Front Elevation and Floor Administrative Capacity, too Patients. Estimated Cost, $60,000. (See illustrations 61

tion, Recreation.

Plans.

and 83

for further description of this institution.)

55

Section II (linin.tj

The

together.

extensions are constructed of frame, covered with shingles that har-

monize with the exterior of the main section, and the windows of the entire building are fitted on the outside with slat blinds in order to shut out the heat and light during the During the remodeling there was also installed a central hot water vacuum sunnncr. plant to heat the entire structure.

These improvements have resulted in providing a group of buildings extending from one centre and admirably adapted to the requirements. They have also doubled the previous administrative facilities, there now being a capacity for one hundred patients, at a cost of

about 850,000.

State Sanatorium, Hebron, Me., Administration Building (Illustration This building is two full stories with a basement, and a third story over the centre. constructed of red brick with gray brick and concrete trimmings for the window caps,

Maine

23). It is

The roof is tar and gravel, drained in the centre because of the danger of The main front is 147 feet long by 53 feet wide, with an extension to the rear one end 66 feet deep by 33 feet wide. The front basement contains a small medical

plates, etc.

snowslides. at

divided into a laboratory, pharmacy, examination and waiting rooms, a sterilizing

suite,

chamber,

billiard

and storage rooms.

In the rear extension of the basement

is

a section

for servants' quarters.

The

first floor is

flanked on the front by a porch 12 feet wide

by 147

feet long

and

wide by 36 feet long. It is divided into a large dining room and an assembly room, both 38 feet wide by 36 feet deep, and connected through the centre

on the south side 10 of the building

feet

by a

corridor with

rooms on both

sides.

On

the front

is

a parlor 17 feet

by 17 feet long, and a waiting room 10 feet wide by 17 feet long. On the rear is a reading room 16 feet wide by 19 feet long and toilets, washrooms and other conveniences. The rear extension on the first floor contains a kitchen 30 feet wide by 18 feet deep, and serving room 16 feet wide by 17 feet deep, pantry, cold storage and servants' dining room 19 feet wide by 16 feet deep. The second floor is divided by a long corridor seven feet wide running down the centre of the building, wdth good-sized rooms on each side for the superintendent, staff, patients and visitors, well supplied with closets, baths, toilets and other conveniences. This story is also fianked on the front by a porch 12 feet wide by 57 feet long, and one on the south side 10 feet wide by 36 feet long. The third story over the centre of the block is devoted to quarters for nurses. The building is intended for administration purposes, offices, accommodations for trustees and visitors, and for the housing of patients who are able to be up and around. The interior is plastered over metal lath with hard plaster, having round corners wide

In-

24 feet long, an ofl&ce 15 feet wide

and sanitary base, thus eliminating

The

entire building

and

is

is

all

angles in the endeavor to

make

it

strictly sanitary.

smooth and simple wood-work an institution of one hundred patients,

as nearly fire-proof as possible, with a

intended to afford administrative

facilities for

at an estimated cost of 850,000.

Iowa State Sanatorium, Oakdale,

Administration Building (Illustration by 70 feet deep, two stories high, with a basement and attic story. The foundations are of stone and the buflding is trimmed with wood painted white, and surrounded by a veranda on two sides of the first floor, the roof of which is supported by large round wooden columns. The basement contains storage rooms and a flining room for the male help. The main entrance hall on 24).

This

is

la.,

a substantial brick xencered structure 63 feet wide

56

Administration Buildings

2CC0N0 TLOOR

PUN

B/OCMCNT

No. 23.—Maine State Sanatorium, Hebron, Me. T. C. Stevens & J. H. Stevens, Architects. Administration Building. \'ie\v of Front Elevation and Floor Plans. Administrative Capacity, 100 Patients. Estimated Cost, $50,000. (See illustrations 11 and 58 for further description of this institution.)

57

Section II the

tirst floor is

12 feet

wide by 30

feet long,

with a physician's suite on one side consisting

by 16 feet long, a small examining room 9 feet wide by 12 feet long, a second examination room 8 feet wide by 16 feet long, and a small passageway 4 feet wide and 9 feet long. On the opposite side of the main hall is a rest-room 22 feet wide by 25 feet long, a small hall 7 feet wide and 22 feet long, running down to the On the l)atients" entrance, and a small reception room 10 feet wide by 12 feet long. dining is large room hall a entrance of the opposite side of the patients' hall and at the end persons, a pantry twenty-five hundred and one will seat 30 feet wide by 43 feet long which 10 feet wide by 22 feet long, a kitchen 16 feet wide by 22 feet long, stairs to the cellar, The second floor, which is divided into quarters a refrigerator, and'other conveniences. of a reception

room

12 feet wide

-ir--'^-

^p^-'f^

-/

JCV

^T^;-

^

I

lij^ a

\

^UA

No. 24.— Iowa State Sanatorium, Oakdale, la. H. F. Liebbe, Architect. Admimstr.\tion BuildiN(;. \iE\v ov Fro.nt Elevation a.nd Floor Plans. Administrative Capacity, 100 Patients. Estimated Cost. 823,000. (See illustrations 29, 84 and 103 for further description of this institution.)

Administration Buildings

No,



25. Manitoba Sanatorium, Ninette, Manitoba, Canada. Designed by Dr. D. A. Stewart. Admixistratiox Building. View of Front Elevation and Floor Plans. Administrative

Capacity, 100 Patients.

Cost, $33,000.

(See illustration 81 for further description of this institu-

tion.)

59

Section II for the nurses

and other

help, has

dining room extends above

much less The

one hundred patients, and cost $23,000, but plant,

which are housed

in

floor area

than the

first,

as the ceiling of the

building has an administrative capacity for

its level.

this

does not include the laundry and heating

another structure.

Sanatorium for Consumptives, Ninette, Manitoba, Canada, Administration Bvilding (Illustration 25). This building has a basement, two stories and an attic lighted by dormer windows. It is 88 feet along the main front by 30 feet wide and has a rear extension 34 feet wide by 36 feet deep. The basement walls are of rough boulder stone, the ground floor of brick veneer, carried on a steel frame, and the second and third stories of frame construction, finished on the outside with stucco upon metal lath. The front and both ends of the building are considerably broken up by windows and dons and are flanked by a porch twelve feet wide. The basement is wholly above the ground in front and extends out as far as the edge of the porch, thus making it twelve feet deeper than the upper stories. It is divided into a main dining-room 27 feet wide by 52 feet long, a kitchen 19 feet wdde by 27 feet long, a servants' dining-room 12 feet wide by 17 feet long, two store rooms about 14 feet wide by 18 feet long, a laundry 16 feet wide by 29 feet long, an ironing room 14 feet wide by 28 feet long and an engine room containing

Manitoba

the steam plant for heating the buildings.

The

room 28 feet wide by 42 feet long and two by 30 feet long, one for men and the other for women, two private rooms each 10 feet wide by 12 feet long, two nurses' rooms 12 feet wide by 12 feet long, a business ofiice 12 feet wide by 16 feet long, an examining room 12 feet wide by 15 feet long, treatment room 12 feet wide by 12 feet long, laboratory 8 feet wide by 12 feet long and lavatories, toilets and closets. The second floor is cut up into rooms for the staff and nurses and the third floor for servants' quarters. The building has an administrative capacity for sixty patients, and cost 833,000, which includes its proportion of the funds expended in heating, plumbing, water and sewage disposal for the entire plant. The pavilions are illustrated under the section on The Lean-to Type of Building. first floor is

divided into a recreation

infirmary wards 12 feet wide

Indiana tration

26).

State Hospital, Rockville, Ind., Administration Building

(Illus-

This structure occupies the centre of a group of buildings, illustrated

under the section on sites and grouping. It has on the front a basement, two stories and an attic under a mansard roof; in the rear an extension of only one story and basement.

The main

portion of the building

structed of brick on a stone foundation.

is

89 feet along the front and 52 feet deep, con-

The

front basement is divided by a long corridor and contains two storage rooms 17 feet wide by 29 feet long with cement floors, a drug room 12 feet wide by 16 feet long, a store room for drugs 16 feet wide by 24 feet long, and a servants' sitting room 17 feet wide by 31 feet long, connected with baths and toilets. The basement of the rear extension is divided into two large storage rooms, a washroom ff)r

servants and a preparation room for vegetables.

The

first floor

has a large reception hall in the centre 32 feet wide by 36 feet long,

running from the front to the rear of the building.

On one side is an office 17 feet wide and a library 16 feet wide by 26 feet long. On the other is a record office 15 feet wide by 25 feet long and two examination rooms 12 feet wide by 12 feet long. At the far end of the reception hall is a wide stairway to the upper floors with a staff dining hall by 26

feet long,

60

Administration Buildings

n

f-lE5T Iruoou

No.

PUAn

<5cco7iD



n__am

ft^oa Pla/1.

26. Indiana State Hospital, Rockville, Ind. Brubaker & Stern, Architects. Administration Building. View of Front Elevation and Floor Plans. Administrative Capacity, 100 Patients. Estim.ated Cost, $50,000. (See illustrations 7,46 and 51 for further description of this institution.)

61

Section II 17 feet

and

wide by 29

on one

feet long

a barber-shop 14 feet wide

the building

is

by 16

a corridor running at

and a dental room 15 feet wide by 16 feet long, on the other. At the rear of this portion of right angles to the reception hall and leading to the

side,

feet long,

patients" pavilions at the sides.

Across this corridor It

is

by 50

the extension, 60 feet deep

contains the dining hall 60 feet wide

by 40

feet deep;

feet wide,

one story high.

a well lighted and ventilated

room, having a high ceiling and provided with a number of small tables each seating Behind it is the kitchen and pantry containing a stairway leading to the

eight persons.

basement.

The second and the superintendent,

third floors of the

staff,

veniences in each story. the estimated cost

main building are divided

into apartments for

nurses and servants, wdth toilets, closets, baths and other conIt

has an administrative capacity for one hundred patients and

was 840,000.

The Preventorium ing (Illustration 27).

for Children, Farmingdale,

This building

is

of

the outside walls, which are of hollow

placed on a concrete foundation.

The

N.

J.,

Administration Build-

frame construction, with a shingle

tile,

roof, excepting

covered externally with cement stucco and

floors are of

yellow pine and

rooms having much wear are covered with linoleum held

in place

all

the corridors and

by brass

strips laid flush

with the flooring material.

No. 27.- Preventorium for Children, Farmingdale, N.

Scopes & Feustmann, and Walter W. J. .\SS(I< lATI 1) AurillTKI TS. AUMIMSTKATIOX BuiLDING. FrONT AND SiDE ELEVATIONS AND Flour Plans, .\d.\u.\istkatio.\ Capacity, 112 Patients. Cost, $35,000. (See illustrations 12, 19 and 95 for further description of this institution.) JrDKI.I.,

62

Administration Buildings The

front of the building

is

On

103 feet long by 36 feet wide and the rear extension

first floor in the main section is a business ofihce 12 by 18 feet deep, reception room 12 feet long by 14 feet deep, staff dining room 17 feet long by 20 feet deep and a doctor's office 1 2 by 1 2 feet. The main dining room occupies one-half of the front section and is 41 feet long by 31 feet deep. In the rear extension is a serving room 25 feet wide by 19 feet deep, kitchen 25 feet long by 19 feet deep, servants' dining room 13 feet wide by 18 feet deep, and cold storage. The second floor is divided in both sections by corridors. On the front is an apartment consisting of two rooms and bath for the medical superintendent, bedrooms for the head nurse and matron, and a staff sitting room. On the rear are two rooms for teachers, a sewing and linen room, a clerk's room and twelve rooms and a bath for the servants. AH the women servants are housed in the administration building, and the men in the third floor of the power house. The two entrances for the children are arranged to give them direct access to the dining room without going through other parts of the building. This building for administrative purposes has a capacity for one hundred and tweh'e children, and was constructed in connection ^^•ith a reception cottage one quarter mile distant which is a separate unit and has a capacity for thirty children. The cost of the administration building was 825,000.

63 feet long by 27 feet wide.

the

feet long

EXAMPLES OF SERVICE BUILDINGS The Municipal Sanatorium, Otisville, New York, Service institution

and

fifty

made up

patients

of a

and

all

number

of separate units;

first

(Illus-

each to house about one hundred

to be administered in a general

The

a central administration building.

the

Building

This was planned to be the centre of a group of lean-tos and cottages at an

tration 2S).

men's unit and contains a

way and about

structure illustrated

is

equidistant from

the service building for

commodious dining room, kitchen, two sun and servants' quarters. where the drainage is good, with a foundation con-

large,

parlors, a well arranged infirmary, nurses' It is

placed on the side of a

hill

first story. As very little excavation was necessary in the front, that part of the basement is mostly above the ground, welllighted and gives practically an extra stor}-. This is used as a bathing apartment, containing a variety of shower-baths and other modern bathing fittings. The building is divided into two sections connected by a passageway 26 feet wide and 35 feet long in which the kitchen and serving room are placed." The front section, 116 feet long by 40 feet wide,

structed of stone which extends to the floors of the

has one story over the basement, of frame construction, covered with shingles.

It is

di\ided into a large dining room in the centre, 67 feet long by 24 feet wide, seating from 120 to 150 persons, and two solaria 39 feet long by 25 feet wide for reading and amusement purposes connected by a terrace in the front of the dining room. The solaria and terrace

are enclosed

by

glass

and sash windows which can be and usually are pushed up out

way, leaving the openings entirely

The by 32

rear of the building

is

of the

clear.

for all practical

purposes a separate structure 66 feet

and as the hill at this point has a steep slope, the floor of the first story is close to the ground and contains the storage, work rooms and other apartments needed by the service staff'. The second floor is used as an infirmary and is divided through the centre by a long hall four feet wide which opens at one end into a Avard 27 feet wide by 60 feet long. On one side of the hall is a two-bed and four single-bed rooms and a locker long

feet ^^'ide,

63

Section II

m Ijjlllli ji.

•li

;i

n

}m.:l '

"it'-<

\\: ~

!•

^Hi

No. 28.— Municipal Sanatorium, Otisville, N. Y. John B. \'a\ Pelt, Architect. Designs of the I)i;P.\KTMENT OF HEALTH. SERVICE BUILDING AND INFIRMARY FOR OnE SECTION OF THE INSTITUTION. \'iE\v OF Front and Side Elevation and Floor Plans. Service Capacity, 250 Patients. Estimated Cost, $.35,000. fScc illustrations 14, 59, 60, 85, 94 and loi for further description of this institution.)

64

Administration Buildings

On the other is one two-bed room, a stairway, baths, toilets and a nurses' room. These are surrounded on two sides by large open verandas upon which all beds can be room. rolled

both from the ward and the private rooms.

The rooms,

third story under a slanting roof

toilets

hundred and

and

is

cut

up

closets for the use of the servant?.

fifty patients at

an estimated cost

Iowa State Sanatorium, Oakdale,

into

two dormitories, four

The

service capacity

is

single

for

one

for construction of $35,000.

la.,

Service

Cottage

(Illustration

29).

This building was erected to provide a kitchen and dining room for an infirmary group consisting of three cottages

No.

all

connected by a covered corridor and built on the

— Iowa State Sanatorixun, Oakdale, la.

lines of

Designed by Dr. H. E. Kieschver. H. F. Liebbe, Service Building for Infirmary Group of Cottages. View of Front Elevation AND Floor Plans. Service Capacity, 20 P.atients. Estim.ated Cost, $6,000. (See illustrations 24, 84 and 103 for further description of this institution.) 29.

Architect.

5

65

Section II

©

No.

IL^ .d.Mka. j^iLaWL

„N^lril

^._

f?

Catawba Sanatorium, Catawba, Va.

Designed by De. Ennion G. Williams. Service CONTAINIXG AX A.MUSEMEXT HaLL. FrONT ELEVATION ANT) FlOOR PlAN. SeRVICE Capacity, 70 Patients. Estimated Cost, $10,000. (See illustrations 17, 69 and So for further 30.

lUll.lJiNC.

description of this institution.)

the inciiMcnt patients'

The Cottage Type two

stories

the rear 21

back of

it,

cottafjjes at

of Building.

The

and a

cellar.

feet

wide by

1.5

the

Iowa State Sanatorium

It is of

illustrated in the section on frame construction on a stone foundation with

first floor is

feet deep,

and two dining rooms 12

feet

stairway leading to the upper story.

divided into three rooms, a large kitchen in

with a small pantry, refrigerator and cupboards

wide by iS

This

floor

feet

deep on the

front, divided

has a porch 11 feet wide

by

by a

53 feet long

across the front with an extension fifteen feet deep to the rear on each side of the building and of the

same width.

The second by

floor

is

dixided into four bedrooms for ser\-ants,

12 feet 6 inches long, a toilet

and bath

S feet 66

wide by

al!

11 feet long

8 feet 6 inches

wide

and a sleeping porch

Administration Buildings or loggia S feet wide

back under the roof

The

by 29

which

is

part of the main structure, being placed

of the building.

service cottage

porches and

feet long,

is

unusual and interesting because of the wide extent of

the simplicity of its floor plans,

with a capacity

for 20 patients, at a

its

low cost

estimated at $6,000.

CfLi.FK

i>IJjr

New Haven County State Tuberculosis Sanatorium, Meriden, Conn. Foote & Towxsend, Arc:hitects. Ser\-ice Buildint;. \'iew of Front Ele\atiox and Floor Plans. Ser\'ice Capacity, 122 Patients. P^stimated Cost, $15,000. (See illustration 79 for further description of

No. 31.

this institution.)

67

Section II

Catawba Sanatorium, Catawba, Va., Service Building

(Illustration

30).

This building is of frame construction, raised on stone piers. It is 108 feet long by 54 feet wide, with a rear extension 30 feet wide by 30 feet deep and a porch eight feet ^^dde on the It is divided into two dining rooms 27 feet wide by 40 feet deep at the front and sides. ends of the building and a large amusement hall 54 feet ^^ide by 27 feet deep between them This hall has a large fire-place and can be thrown open in connection with in the centre. the two dining rooms six

by

raising

windows

in the walls

between them.

The building has by wdndows in

entrances on the \-eranda and the front and sides are well broken up

order to give the patients open air dining and sitting rooms.

Directly behind the hall

is

by 37 feet deep, housed partly under the main roof and partly The kitchen is connected to each dining room by pantries or serving in the rear extension. rooms 13 feet wide by 13 feet deep and has in the rear a bakery 13 feet wide by 18 feet deep, a store room 21 feet wide by 13 feet deep, and a refrigerator. This plan for a service building is to be commended and well illustrates the reasons the kitchen 27 feet

•\\dde

for constructing a separate structure to

open

air dining

ser\'ice

rooms,

It is

house this department, as

cross-ventilation

and

light

it

provides under a roof

from every

direction.

It

has a

capacity for seventy patients at an estimated cost of Sio,ooo.

New Haven 31).

mth

This building

County Tuberculosis Sanatorium, Meriden, Conn. is

one story with a

cellar, of

constructed in two sections, the front being 53 feet wide

by

26 feet deep.

extends under the entire building with a floor laid in cement and the exception of a

room where the heating plant

the entire front of the building and

is

flUustration

frame construction, on a stone foundation.

52 feet wide

is

installed.

by

is

The

cellar

used for storage with

The dining room occupies

25 feet deep.

It

is

entered through

by 22 feet long and is furnished with twelve tables, seating ninety-six persons. The room is well lighted and ventilated, but is not an open air pa\dHon. At its rear in the extension is a serving room 25 feet wide by 15 feet deep, and behind this the kitchen 25 feet wide by 30 feet deep, furnished with a large refrigerator, a small toilet, dumb-waiter to the storage rooms below and connected with the cellar by stairs, which leads to a cold storage plant. It has a service capacit}- for one hundred and twenty-two patients at an estimated cost of 820,000. a vestibule from a porch 8 feet wide

68

SECTION

III

Administration Buildings and Patients' Quarters Combined

SECTION

III

Administration Buildings and Patients' Quarters

The Need

for

Combined

Combination Buildings

rapid growth of pubHc opinion in regard to the necessity of caring for and isolating the advanced tuberculosis patient and the growing beUef that the spread of this

The

disease cannot be checked without the removal of

advanced cases from the homes

of the

poor and ignorant, has caused a continually increasing number of hospitals to be constructed during the past two years, designed to house the entire institution under one roof. It is claimed for this style of building that it is possible to economize on the installation of the plumbing, heating, and administrative arrangements, that it concentrates the work, and is particularly good for city use, where property is valuable and a site cannot be obtained at a reasonable cost for the erection of the pavilion t}qpe of hospital, or one-story lean-tos

and cottages spread over a large area of ground. These buildings may be used for housing either incipient or advanced cases of tuberculosis, and are planned and constructed on lines conforming in many ways to the needs of a general hospital. As they are intended usually for the service of small communities and are often placed on the outskirts or

^^-ithin

towns or

cities

the site selected

should be near the line of an electric car system, with enough land to allow of the free circulation of air possible,

on

one for the

all sides of

staff,

Two

the building.

patients

and

their friends,

entrances should be provided

and the other

for

when

merchandise and

service.

Planning Combination Buildings In designing these buildings there should be provided for all advanced cases, single bedrooms or rooms with not more than two beds in each, and for incipient cases small wards of not more than six patients or rooms for two patients each. Every patient housed

under the main roof should have two thousand cubic feet eight feet wide

As

fire

by ten

feet deep, or at least large

protection

is

compulsory

concrete, brick, terra cotta or concrete

enough

many

in tile

of air space

and a porch area and table.

for a bed, reclining chair

cities it is

suggested that reinforced

construction with reinforced concrete floors

be adopted, as buildings erected in this manner are practically non-combustible. structure should be wired for bells or telephonic communication

when

it is

The

wired for lighting,

all rooms to be used by patients. The be finished in hard plaster, painted and varnished. The corners

as bell calls or telejjhones should be installed in walls

and

ceilings should

the wall angles and at the ceiling and floor should be rounded. Light colors may be used on the walls instead of a dead white; in fact, a harmonious color scheme throughout

in

the entire building

and contented.

A

is

an advantage, as

ventilating system

it is is

one of the means for making patients happy

not necessary in these buildings, but

space possible should be used for windows.

The 70

all

the wall

floors of the interior, except the toilets,

Administration Buildings and Patients' Quarters Combined



Eastern Maine Hospital, Bangor, Me. T. C. & J. H. Stex'exs, Architects. Illustila.ting A ]\Iethod of Protecti-xg a Sleepixg Porch witk Heavy Wire Netting. Useful when a Porch Faces a Street or to Pre\'ext Patients from Lea\ing without Pekiiission.

No. 32.



No. 33. United States Hospital for the Insane, Washington, D. C. Showing a ^Iethod of Inclosing a Sleeping Porch with Swinging Sash Frames; Useful for City Hospitals with Porches Having Various Exposures.

Section III

72

Administration Buildings and Patients' Quarters Combined baths, laundry

narrow board

and kitchen, should be

floors,

of

hard wood, treated by

covered with battle-ship linoleum.

Other

oil

floors

and wax, or ordinary which come in contact

with an unusual amount of water should be of terrazzo, cement, composition floorings.

patent

tile,

or of one of the

the doors and passageways should be wide enough

All

beds through them; that is, not less than three feet six inches. There should be no door sills or panels in the doors; and all the interior finish around them and the windows should be placed flush so as not to produce projections or corners which will catch the dust. The building should be constructed on the sanitary principles laid down for general hospitals, and the rooms for advanced cases and all the porches screened with wire netting which can be removed during the cold weather. for the easy rolling of the

The examples

of building

and

floor plans

given are not

all

each one offers some suggestions, not found in the others, which

model arrangements, but

may

be of use to designers

of this class of institutions.

Rooms

for Administrative

The

Purposes

building should contain for administrative purposes the following rooms:

Dining Room for Patients Dining Room for Staff Dining Room for Servants Kitchen Diet Kitchens

Superintendent's Quarters Physician's Quarters Nurses' Quarters Servants' Quarters

Sewing Room Linen Room

Bakery

Room

Serving

Rooms Rooms Bath Rooms Store

Dish Closet Cold Storage

Sink

Physician's Office Special Treatment

Toilets

Room

Laundry

Waiting Room Laboratory

Disinfecting

Drug Room

Morgue Autopsy Room Heating Plant

Business Office

Room

Sitting

Room

Crematory

Workshop

Library

Coal Storage

EXAMPLES OF COMBINATION BUILDINGS Sharon Sanatorium, Sharon, Mass.

This

(lUustration 34).

is

one of the oldest

and was

buildings in America constructed for the open air treatment of tuberculosis

planned to be an administration building and patients' quarters combined. Its continuous use for fifteen years has demonstrated its convenience for housing incipient

and moderately advanced

cases.

Any one

planning to build a sanatorium and desir-

ing to have a complete unit under one roof, particularly

if

there

is

a farm house or country

residence on the site selected, will find this a convenient design to adopt, as the original structure

both sides

can be used for administrative purposes and an extension added on one or By using this method it is possible to build a compara-

for patients' quarters.

tively cheap sanatorium

The

if

the patients' quarters are constructed in an economical way.

extension in the illustration runs from the dining-room and includes the sun parlor,

with the

toilets,

baths,

and

closets, in the rear of the hall. 73

The

sleeping porch

is

wide

Section III

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74

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Administration Buildings and Patients' Quarters Combined

L-JiiJL^J

No. 36.

— Tuberculosis Hospital, Washington, D.

^IiLES

D\\ & Brother,

.\rchitects.

C.

Floor Plans.

nR5T^.^i7:()Nii

Designed by Dr. George C.ap.\city, 120 P.a.tients.

Kober. Fr.vxk Cost, Sioo.ooo.

yi.

Section III enough to give plenty of room for the patients to move around at the sides of the beds, and is protected, when necessary, from the sun and rain by a canvas awning which can be The doors from the private rooms rolled up out of the way, leaving the porch uncovered. opening on the porch are made wide enough for the beds to pass through them. It is suggested that an improvement to this building can be made by putting in Dutch doors below all windows opening on the porches and by placing a glass roof under the canvas curtain which protects and covers the sleeping balconies, as such a roof would not shut out the light from the rooms

more durable than be constructed

drawn back and woiild be bedrooms opening on the porches can the beds are chiefly out of doors and the rooms are

when

the curtains are

Also, that the

c?.nvas alone.

of a smaller calibre, as

The building has

used merely for dressing.

The

a capacity for twenty-five patients.

estimated cost was 845,000.

The Tuberculosis Hospital, Washington, D. was

hospital

remarkably low

built at a

and

cost,

is

C. (Illustrations, 35 and 36). This way it is planned to

interesting in the

house advanced and incipient, white and colored, male and female patients; each group The hospital is planned to provide a separate wing or on a different floor.

in

wards on the first floor for white and colored males and the second floor is arranged in the same manner for white and colored females. The incipient cases of both sexes, white and These open wards colored, are housed in open-air wards on the third and fourth floors. are roof gardens with casement windows on the north, but are entirely open on the east,

accommodations

who

separate

in

are in the later stages of the disease;

south and west

A

sides.

arrangement

careful study of the

to the different classes of patients,

front feet

is

two hundred and ten

The

through the centre.

on the upper

feet

is

wards, noting the allotment of floor space

The length

by twenty-five

feet

of the building along the

wide through the Avards, and

side extensions are eighty-two feet long

floors is fifty feet long,

but as

the entire length in the basement.

it

runs into the side

The basement

store rooms, boiler rooms, refrigerator,

feet

of the

interesting.

hill it

has not been excavated

contains a large dining room, kitchen,

postmortem room, and morgue.

The arrangement of the first and second floors is the same, the side wards being 48 long by 25 feet wide, the sun parlors 25 feet deep by 14 feet wide, and the rest of

the floor space divided into rooms for offices, toilets, diet kitchen,

used

and the other

accessories

in a general hospital.

The wings and wards, two

71

feet

The

of

the

centre

extension on

long

by 24

the third floor are used as three large open-air

feet

wide,

building on this floor

and one 57 is

divided in

feet

by

long

much

as apartments for the nurses.

an open-air ward, 28

opening into

The

it

feet

from the

Over the main part

wide by 44

feet long,

of the building

with

toilets,

25

feet

wide.

manner as the patients and

the same

the lower stories, but the rooms are used as toilets and baths for

is

fifty

and the rear extension

baths,

on the fourth floor and dressing rooms

rear.

weU finished on the interior in hard wood, giving a good substantial appearance, and there is a commodious electric elevator. The institution is well worth a visit, not only because of its unique arrangement, but also because it will offer many suggestions to those who have to solve the problem of building

is

a substantial brick structure,

housing tuberculous patients in large, congested

and twenty beds, and

cost to erect

and

cities.

It has a capacity of

furnish, $100,000. 76

one hundred

Administration Buildings and Patients' Quarters Combined

'1-

"t 11

i

No. 37.

iiilitiiitiii^ll

—Lady Grey Hospital, Ottawa, Canada. Elevatio.n and Floor Plans.

Weeks & Keeper,

Capacity, 45 Patients. 77

Architects. View of Front Cost, $60,000.

Section III

The Lady Grey Hospital, Ottawa, Canada (Illustration 37). This building was erected by the Ottawa Anti-tuberculosis Association and furnished by the Daughters of the Empire, then handed over as a gift for the people to be maintained by the city. It is situated within the western limits of Ottawa on an elevated site, with sloping ground beside a beautiful grove of mature maples forming a little park with seats and hammocks in the shade for the patients during the hot days of summer. The building is a three story structure with a large basement constructed of hard local red brick, laid in

white mortar, on a concrete foundation, with Indiana limestone

trimmings, following closely the modern English residential style of architecture.

It faces

southwest and has a number of large verandas screened by wire against insects, which open into the different wards by wide doors through which the beds are wheeled.

The main

front of the building

is

130 feet long by 45 feet wide, and the rear extension

by 21 feet wide. The basement contains a laundry 22 feet wide by 20 feet deep, drying room 10 feet wide by 8 feet deep, laboratory 12 feet wide by 14 feet deep, storage for furnace coal 20 feet wide by 12 feet deep, furnace room for two boilers for the heating plant 12 feet wide by 20 feet deep, and a room for elevator machinery 6 feet wide by 8 feet deep. The main portion of the first floor is divided through its entire length by a corridor Beeight feet si.x inches Avide, having on the front a veranda 72 feet long by 12 feet wide. tween the veranda and the corridor are six single rooms 10 feet wide by 12 feet deep and at each end of the corridor on the front are two wards of the same size 18 feet wide by 18 feet deep, for three patients each, with a small veranda extending out from them at the sides of the building, the one on the right being 8 feet wide by 22 feet long and the one on the left 10 feet wide by 14 feet long. The entrance hall is in the centre of the building 14 feet wade by 15 feet deep, with the main stairway leading up on one side and a locker room on the other. On the rear of the corridor is the patients' dining-room 22 feet wide by 20 feet deep, a doctor's office 10 feet wide by 14 feet deep, an examination room 6 feet wide by 8 feet deep, a parlor 16 feet wide by 12 feet deep, a nurses' room 10 feet wide by 14 feet deep, and toilets and baths for both men and women. In the rear extension on the right of the building, back of the dining-room, is a kitchen 22 feet wide by 14 feet deep, servants' dining-room 10 feet wide by 10 feet deep, serving room, pantry, refrigerator room is

41 feet deep

and store rooms.

The second floor is arranged same dimensions,

in the

The

same general arrangement planned

same way as the first, with verandas on the front rooms and two wards in front of a corridor running the entire length of the Ijuilding, and in its rear a large ward over the dining room 22 feet wide by 20 feet deep, toilet and baths for women and men, a matron's room 14 feet wide by 18 feet deep, two nurses' rooms 14 feet wide by 12 feet deep, and a locker room for i)atients. In the extension is a diet kitchen 9 feet wide by 6 feet deep, a nurses' dining njom 14 feet wide by 13 feet deep, a nurses' sitting room 21 feet wide by 21 feet deep, and a small hall three feet wide, running into the main corridor at a right angle.

and

sides of the

third floor also has the

six single

except that there are no side \-erandas and the extension toilet for the servants.

The

steam, has an ele\-ator and

is

for the lower floors,

divided into bedrooms and a

building has a capacity for forty-five patients,

dumb

waiters,

and cost S6o,ooo. 78

is

heated by

Administration Buildings and Patients' Quarters Combined

First Flooe- Plj\m

No. 38.

Second Floor Plan

— Lake Edward Sanatorium, Lake Edward, Province of Quebec, Canada. iiAxx, Architects.

Capacity, 26 Patiexts.

of

as

This building

is

exterior.

of

Quebec, Canada is

In order to protect the interior from cold

as possible the walls are constructed in layers from the outside in, as follows:

shingles, paper, siding, paper, siding, studs,

wood throughout. their

Feust-

placed on a stone foundation two feet thick, and

frame construction, with a shingled

much

&

Ele\'atiox, Floor Plans. Cost, $26,000.

Lake Edward Sanatorium, Lake Edward, Province (Illustration 38).

Scopes

View of Front axd Side

rooms

The

to the

wooden

lath, plaster.

All patients are provided with porch space

The

floors are

hard

and can be wheeled from

veranda assigned to them.

is 87 feet long by 25 feet wide, with two extensions in the rear, one 28 feet wide by 19 feet deep, and the other 28 feet wide by 54 feet deep; each porch

building

was designed

as a loggia,

and

is

a part of the structure under the main roof. 79

Section III The left of

floor

first

the illustration,

the

of first

main

section

is

divided as follows:

Beginning on the

a loggia, called the west porch, 19 feet wide

by 10

feet deep,

then a patients' room 9 feet wide by 12 feet deep, an ofi&ce 9 feet wide by 12 feet deep, a ]i\-ing room 2}, feet wide by 12 feet deep (from which extends in front a loggia or the south

porch 24 feet wide by 11 feet deep), a drug-room 9 feet wide by 12 feet deep, a medical wide by 12 feet deep, and a loggia (the east porch) 19 feet wide by 10 feet deep.

office 9 feet

At the rear of these apartments is a corridor six feet wide, connecting the two corner porches and behind it is the main entrance and stairway to the second floor, a men's toilet 9 feet wide by 4 feet deep,^and two alcoves 9 feet wide by 4 feet deep. On the west end of the building in the rear is the smaller extension, divided down On one side of the the centre by a hall four feet wide, opening into the main corridor. passage are two patients' rooms, one 10 feet wide by 12 feet deep, the other 9 feet wide

On the other side is a coat room 9 feet wide by 7 feet room 5 feet wide by 10 feet deep, a locker room 5 feet wide by 10 feet deep, and the toilet room for women 5 feet wide by 8 feet deep. In the extension on the east of the building is a dining-room 14 feet wide by 23 feet long, a pantry 11 feet wide by 15 feet long, a kitchen 15 feet wide by 18 feet long, a servants" loggia or porch 7 feet deep by 14 feet wide, a servants' sitting room 10 feet wide by 14 feet long, the service and cellar stairway, refrigerator and store room. On the second floor the building is divided by a corridor practically in the same way as on the first, with six rooms each 9 feet wide by 12 feet deep, on the front for patients, and an east, west and south loggia of the same dimensions as those on the first floor, the south porch being reached by a smaU hall four feet wide, in the centre of the building. In the rear of the corridor is a small loggia on one side of the main stairway and a coat room on the other. The west extension is divided into a bedroom and sitting room for the superintendent, a nurses' sleeping room, closets, toilets, baths and a linen cupboard. The east extension is di\'ided down the centre by a hall opening into the main corridor ^nth two rooms for patients, a store room, maid's room and a refrigerator room on one side, and a pantry, lockers, baths and two maids' rooms on the other. The third floor has also the same general arrangement. Six single rooms for patients on the front with a corridor in their rear, an east, west and south loggia, all somewhat smaller than those on the floors below, two rooms for patients in the west and five in the east extension, together with baths, toilets, and lockers, placed at convenient by

1

2 feet

deep, and a linen room.

deep, a bath

l)oinls.

The

building

dividual room.

is

There

a complete institution in is

itself,

supplying each patient with an in-

a heating plant in the cellar,

lighting purposes on the premises.

The capacity

is

and

electricity

is

generated for

twenty-six beds, housing

all

classes of

patients, at a cost for construction of $26,000, or $1,000 per patient.

Franklin County Tuberculosis Hospital, Columbus, Ohio (Illustration 39). is constructed of brick on a stone foundation, in one long block with two small rear extensions. It is two stories high and has a basement under the entire building, and a third story over the centre. The building is one hundred and ninety-six feet This building

along the front and for convenience of description can be divided into five sections: the centre or administration block

is

60 feet long by 41 feet wide, the sections on each side, by 60 feet deep, and beyond these are ward sec-

including the extensions, are 28 feet wide tions 40 feet long

by 32 feet wide. The general plan of each floor is alike in the centre rooms in the front and back divided by a corridor which ends in wards.

of the building, with

80

Administration Buildings and Patients' Quarters Combined

No.

39.

—Franklin

TEL'TS.

County Tuberculosis Hospital, Columbus, Ohio. Howard & Merriam, ArchiFront Elevation and Floor Plans. Capacity, 100 Patients. Estimated Cost, $83,000.

Section III by morgue lo feet wide by iS feet, receiving room in connection with the morgue 23 feet wide by 18 feet deep, and the elevator shaft; on the rear a drying room 23 feet wide by 12 feet deep, a stairway, toilets, and a storage room. The first floor is divided in the centre by the entrance hall ten feet wide, which

The

central block contains in the basement, on the front a chapel i6 feet wide

iS feet deep, a

opens at right angles into the main corridor, with the stairway to the upper stories opposite the door. On the front are the public ofi&ces, doctor's office, and examining rooms. On the rear are four private rooms

The second offices in

floor is

and two locker rooms.

devoted to the children's department.

the front Are two wards 23 feet wide

for bovs.

by 18

feet deep,

Over the executive

one for

Opposite on the rear are the locker rooms, linen rooms and

girls,

toilet

the other

rooms

in con-

nection with them.

by the corridor which runs through the and that portion of them not under the main roof is twenty-four feet deep by twenty feet wide. In the basement on one side in the rear is the laundry, and on the other the kitchen, both 22 feet deep by 17 feet wide. In the front are the service stairways, janitor's department, machinery room and a sterilizing room. On the first and second floors are the toilets and baths, private rooms and diet kitchens. On the third floor in the rear are two wards, 17 feet wide by 22 feet deep, one for men and the other for women. In the front are the toilets and baths and linen rooms. The ward sections, 20 feet wide by 39 feet long, are not used in the basement, but on the first and a second floors are alike, having in front an enclosed porch or solarium

The

extension sections are also divided

central block

by 39 feet long. This building is intended for

9 feet wide

cases and is designed to bring under one hundred patients at a cost of $80,000.

all classes of

roof an entire plant with a capacity of one

County Tuberculosis Sanatorium, Hartford, Conn.

(Illustration 40).

This

is

a small building, consisting of a remodeled farmhouse used for administration purposes to

which has been added a rear extension for housing the patients.

frame construction, two

stories high, the original structure

The

building

is

of

being 40 feet wide by 36 feet

deep and the extension 93 feet long by 28 feet wide, including the veranda. There is a cellar under the main building but no excavation under the extension except for a tunnel carrying the steam pipes from the cellar in the administration building to the dressing and toilet

rooms.

The

first floor of

the administration section

is

divided into a reception room 15

wide by 12 feet deep, an entrance hall 11 feet wide by 12 feet deep and an office 12 feet wide by 12 feet deep. At the rear of these rooms is a dining room 14 feet wide by 23 feet long and a kitchen 12 feet wide by 15 feet long, connected with a serving room, feet

On this floor a passageway three feet wide conroom with the patients' quarters which are divided into four single rooms 7 feet wide by 8 feet deep and a ward 48 feet long by 14 feet deep cut up into six cubicles eight feet wide. This ward opens on to a veranda twelve feet wide and into a dressing room at the far end of the extension 16 feet wide by 26 feet deep, containing toilets, baths and lockers. The second floor of the administration section is divided into four bedrooms, two 12 feet wide by 15 feet long, one 9 feet wide by 16 feet long and one 11 feet wide by 12 feet long, a stairway and a hall connecting it with the extension. This floor of the patients' fjuarters is arranged in the same manner as the first floor, with the exception of the addition pantry, closet and stairway to the cellar. nects the dining

82

Administration Buildings and Patients' Quarters Combined

reM" CL.:-

"^^

^^

imi

i ...

,

\\

No. 40.—Hartford County State Tuberculosis Sanatorium, Hartford, Conn. Foote & Townsend, Architects. View of Front and Side Flevations and Floor Plans. This is a Remodeled Capacity, 33 Patients. Estimated Farmhouse, with an Open Ward Extension in the Rear. Cost, .$15,000. 83

Section III

XCOND

TLOOR PLAN

EfnDDamDDDD 1^

F123T nOOI^

No.

41.

— Cuenca

of a prix'ate

PUH

Sanatorium, Bass Lake, Minn. Alfred H. Wheeler, Architect. AND Floor Plans. Cap.a.city, 28 Patients. Cost, Sg.coo.

room

8 feet

by

S feet

next to the main building.

and

a nurses'

The capacity

bedroom 14

feet long

of the building

is

by

Elevation

S feet wide, placed

thirty-three patients at an

estimated cost of 815,000.

The Cuenca Sanatorium, Bass Lake, Minn.

(Illustration 41).

This

is

a frame

building on a stone foundation, with two stories and a cellar, e.xtending out from the first floor.

The

building

is

34 feet

and two wings or porches wide by 60 feet deep and the

wings are each 65 feet long by 13 feet deep.

On the first floor is a dining and Uving room 35 feet \Aide by 24 feet deep, a kitchen 20 feet wide by 24 feet deep, a small pantry, hall, sleeping room for the cook, and storeroom.

On

the second floor are four private rooms 10 feet wide

by 14 feet long, a small corriand two wards, one 10 feet wide by 20 feet long, with three beds for women, and the other 16 feet wide by 23 feet long, with five beds for men. The basement contains the laundry, and a boiler room, where a gasolene pumping engine is installed to supply two large water tanks. dor four feet wide, closets,

toilets,

baths,

The wings or sleeping porches are eight feet in the clear to the ceiling and separated from the central portion of the building by a room containing the toilets, baths and lockers for the patients. Their fronts are open, but protected in stormy weather by canvas curtains, and cross-ventilation is obtained through windows in the rear walls. The dressing rooms in this building are inadequate for ten patients and would be better if located behind the porches and so arranged that the patient would not have to walk so

The porches should be wider and divided order to house the patients in smaller groups.

far to reach them. in

by one

or

more

partitions

Administration Buildings and Patients' Quarters Combined

DD No. 42. -Association Sanatorium, Colorado Springs, Colo. Elevation and Floor Plans. Capacity, 24 Patients.

D

aDDDDDD

N. Van den Arend, Architect. Estimated Cost, 82^.000.

building has a capacity for twenty-eight patients, and cost, including water

The

supply, plumbing and sewage disposal, $9,000.

It is

one of the

first of

a

new type

of a

complete plant under one roof for small institutions housing tuberculous patients, and the following buildings illustrated in this section are of the same type, but with some improvements.

Colorado Springs Association Sanatorium, Colorado Springs, Colo.

(Illus-

These plans were designed for a small temporary reception hospital to house all classes of patients under one roof. The building is to be frame construction on a stone foundation, covered externally with shingles, and should make an artistic and attractive structure. The building consists of a central section 25 feet wide by 80 tration

42).

feet deep,

having a basement and two

the sides 86 feet long

by 24

stories,

with wings or porches extending from

feet wide.

The basement contains rooms for the heating plant, storage of coal and supplies. consists of a sitting room 25 feet wide by 30 feet deep, a dining room 25 feet wide by 16 feet deep, a kitchen 16 feet wide by 22 feet deep, a pantry 8 feet wide by 12 The second floor is feet deep, store-rooms, and an office 11 feet wide by 12 feet deep.

The

first floor

one apartment

of four rooms, all 14 feet

wide by 14

feet deep,

and

toilets,

baths and

closets for the use of the nursing staff.

have the same general arrangement as the Cuenca Sanatorium, with the exception that all the patients are to have separate dressing rooms at the back of the porches; this will make the wings more commodious and is an improve-

The plans

of

this building

8^

Section III

No. 43.— District Tuberculosis Hospital, Lima, Ohio. McLaughlin and Hulskin, Architects. \ IKW OF [ KONT ANIJ RkaK I-;i.E\ATIO.\.S A\U FloOK Pi.AXS. PRESENT CAPACITY, 28 PATIENTS. WiNGS Tu BE KxTEXDED AS Shown IN Floor Plans WITH A CAPACITY FOR loo Patients. (For plan of basement see illustration No. 20.) Estimated Cost, Sioo,ooo. 86

Administration Buildings and Patients' Quarters Combined The bathrooms and

ment.

be made more convenient

if

toilets are situated

next to the main building, but would

The capacity

placed in the rear of the wings.

will

be for

twenty-four patients at an estimated cost of $25,000.

Ohio (Illustration 43) This building wooded grove two and one-half miles from

District Tuberculosis Hospital, Lima, is

situated on a site of fifty-five acres in a well

.

Lima, Ohio, on the Western and Interurban Electric Road.

It

constructed of brick, on

is

stone foundations, with brick porches facing the south at the rear, and three sections:

is

divided into

the centre for administration purposes, and two wings for the patients'

quarters.

The

front of the administrative section faces the north,

the servants' dining

room

14 feet wide

bakery 14 feet wide by 20

feet long,

by 24

and

its

basement contains wide by 24

feet long, the kitchen 22 feet

feet long, pantry, vegetable

and grocery

laundry, heating and powxr plant, cold storage rooms, toilets and trunk (See Illustration No. 20.)

mortuar}'.

The

first floor

long, a pantry,

20 feet wide

by 14

store rooms,

room and a

by

contains a general dining

and dish

room 24

sterilizing

21 feet long, with lockers,

room

feet long

bath and

for patients, 27 feet

by

8 feet wide,

toilets, staff

wide by 29 feet

two dressing rooms

dining

room

18 feet long

wide by 14 feet long, reception room 14 feet wide by wide by 14 feet long, private office 11 feet wdde by 14

feet wide, store-room 12 feet

19 feet long, general ofl&ce 10 feet

room 5 feet wide by 14 feet long, drug room 12 feet long by 7 feet wide, by 6 feet wide and matron's room 11 feet wide by 14 feet long. The second floor contains sixteen rooms all about 10 feet wide by 13 feet deep, and baths and toilet for the staff, nurses and servants; also two large dressing rooms with lockers and toilets arranged in the same manner as on the floor below, for the patients feet long, x-ray

library 12 feet long

in the pavilions.

The two

sections of the building used as patients' quarters are divided into single

wide by 12

which face the south and open in front on to a porch toilet and dining rooms. One of the institution's most interesting details is the arrangement of the patients' lockers or closets 3 feet wide by 2 feet deep between the windows in the corridor at the rear

rooms

8 feet

feet deep,

wide and in the rear on a corridor leading to the dressing,

fifteen feet

of the rooms.

The

building was planned to have a capacity of one hundred patients housed in

separate rooms in the pavilions extending from the administration section and ending at

the far end in a sun parlor or sitting

room 20

feet

wide by 35 feet long, but as the funds

to complete the original plans as illustrated were not appropriated these pavilions are

At present

unfinished.

there are only rooms for twenty-eight beds, the ends of the wings

with a number of rooms and the sitting rooms not having been

completed as more room

built,

but they

will

be

needed.

This includes a water tower one hundred and from an artificial lake constructed for the hospital, the power the basement, plumbing and administration facilities for one hundred patients.

The

present building cost $80,000.

twenty-six feet high plant in

is

filled

Plan for a Small Village or

Town Sanatorium

(Illustration 44).

This

is

a

design for a small tuberculosis hospital or sanatorium to house an entire plant under one roof.

It

has a capacity for fourteen patients, but the dormitory wings can be built two

stories high

and the number increased

to twenty-four.

It

is

an interesting and com-

pact design for a small village or town institution housing incipient cases, and the floor

Section III

No. 44.— A Design for a Small Village or Town Hospital or Sanatorium. Front Elevatiox axd Floor Plan. Capacity. 14 Patients. Estimated Cost. 815,000.

plans can be adapted for advanced cases without greatly adding to the expense of construction, by increasing the length of the dormitory wings eight feet, and placing partitions

between the beds.

The

first floor

should be built of brick or reinforced concrete on a stone

foundation with a basement under the entire structure:

the second floor walls of stucco

on metal lath finished in colors or with dashed pebbles, and the roof of stained shingles. The building will be one hundred feet along the front by twenty-four feet deep through The dormitories 14 feet wide by 25 feet long, and the porches 7 feet wide by the wings. front walls dividing the dormitories from the porches are constructed windows between, which can be pushed up out of the way, leaving the space entirely clear. There are also windows in the rear and side walls giving good crossventilation. At the end of the dormitories next to the central section of the building The lockers are 3 feet wide by 3 feet are bathrooms, toilet and lockers for the patients.

32 feet long.

The

of pillars with

deep

in

order to give a small private space to each person.

is divided into a reading room 1 2 feet long by room 17 feet long by 12 feet wide, a kitchen 13 feet long by 14 feet wide and a pantry. The second floor contains two small wards for two patients each and a nurses' apartment divided into a sitting room, bedroom and bath. The entire building is to be heated by a steam plant in the cellar and should be The estimated situated so it can be connected with the city sewers and lighting service.

The

central section of the first floor

12 feet wide, a dining

cost

is

Si 5,000.

88

SECTION Hospitals for

Advanced

IV

Cases, Infirmaries and Reception Hospitals

Section

Lnrrr^

sir—

j

IV

n.

Z

•"

2

|

H''

I

r

[

[

1

J-i->, (

90

6>

SECTION IV Hospitals for Advanced Cases, Infirmaries and Reception Hospitals

The

three types of buildings grouped together in this section for description, are

intended for patients

who need

comfort, good nursing, and the housing supplied

by a same general purposes, that is, for the care of cases too sick to look after themselves, and at many institutions one building serves the purpose for which all are constructed and therefore it is hardly possible to separate them all

They

general hospital.

are used for the

for purposes of description.

Hospitals for Advanced Cases

These buildings patients

for

who

are

are

intended,

unable,

as

their

because of

the

name

indicates,

to

advanced condition

house and care of

their

disease,

open cottages. They are usually built on the lines of a general hospital, either the entire plant under one roof (as described in Section III) or on the pavilion plan. Also sometimes as a separate pavilion in connection with a general hospital or sanatorium in the open country. An advanced case hospital does not mean a home for incurables, for there can be no hard and fast line of demarcation drawn between curable and incurable cases. It has been found that many patients sent to institutions where they may be isolated until their to live in lean-tos or

death, improve under good hygienic surroundings and recover for It

is

the opinion of

open

air

of cold

many

authorities that the

all

practical purposes.

advanced case does better on a porch

in the

than in an enclosed room and can stand with benefit a comparatively large amount

and exposure.

It is therefore necessary that buildings for this purpose, besides

being heated, and supplied with the comforts and conveniences of a general hospital, must also

have large verandas connected with the wards and rooms by windows, cut down to

the floor, and doors through which beds can be rolled, in order to provide the for the

open

air

treatment necessary for incipient cases.

same facilities Such porches should be used in the disease, as there is hope for

by patients, even when far advanced in when they are not in a dying condition. Where very ill patients are to be cared for, it will give them comfort and save much labor if the rooms and porches are connected by some arrangement such as the Indiana pleasant weather all,

Convertible Sleeper, installed at the Indiana State Hospital (Illustration 46), which consists of a space three feet six inches wide across the entire front

between the porch and

room, enclosed on the outside by a glass and sash window that can be raised or lowered, and on the inside by glass doors that can be opened or shut. In this clear space between the doors and windows

when

is

doors and windows are both open, the front of the It is

is cut off from the room when the window is lowered. If room is entirely clear to the porch.

placed the bed, three feet wide, which

the doors are closed, and cut off from the porch

claimed for this arrangement that patients can be exposed to the Q[

air

on the porch,

Section

I\'



Indiana State Hospital, Rockville, Ind. Brubaker & Steex. Architects. " Cox^'erteble Sleeper," Showing ARRAXCEiiEXT for Coxxectixg Rooms -mTH Opex Porches, ix Order to Expose the Patiexts to the Outer Air or Place Them ix Heated Rooms \\TTHorT ]Mo^'IXG the Beds. (See illustrations 7. 26 and 51 for further description of this institution.;

No. 46.

or

removed from

it

and placed

in the

heated rooms,

^\'ithout disturbing

them

or

moving

the bed.

An

essential point to

be considered

in

planning buildings for advanced cases

is,

that tuberculous patients in the last stages of the disease are A-ery annoying to each other,

and should therefore be housed in separate rooms instead of wards. They are easily affected by disturbances, and any excitement, such as grief, anger or worn,-, is usually followed by a fit of coughing and depression. Coughing is not only bad for the individual, but when patients are housed in wards, it may disturb ten or fifteen others, and is also a strong suggestion which often causes an epidemic of coughing among them. The mistake and cruelty of placing in one room a number of persons suffering from a serious chronic disease is only just beginning to be appreciated: and there is no doubt that many patients

who

fail

to

make

satisfactory progress against disease

improve when removed to the quiet and privacy

when housed

in wards, rapidly

The single room more expensive to construct than the ward buildings, but they have advantages and it is easier to manage patients housed in them. The psychological tendency of a private room is to make patients more contented, and also to increase their self-respect. Advanced case hospitals are built not only in order to care for the patient, but also to prevent the spread of pulmonary tuberculosis, which is due in a great measure to the cases of consumption which remain and die in their homes infecting other members of their families. If all advanced cases could be cared for in hospitals, the disease would more rapidly disappear. Public opinion at present will not allow the passage of laws compeUing persons in the advanced stages of this disease to enter institutions for their segregation; of a separate

room.

pavilions are slightly

therefore, hospitals should be

made comfortable and home-like

in

order to attract the

patients and hold them.

There are now in use for advanced cases at open air sanatoria pavilions constructed on the lean-to plan with the porches divided into single rooms and finished with plaster on the interior.

They

are closed in front with glass 92

and sash windows and make very

satis-

Hospitals for factory quarters

Advanced Cases,

when

heated.

It is a simple

viding plenty of porch space and

advanced

cases,

Infirmaries and Reception Hospitals

is

method

economical.

A

of housing, has the

advantage

of pro-

lean-to for sixteen patients finished for

can be built for from $5,000 to Sio,ooo, and when near an administration

bui.ding, administered as easily as a

more

costly structure.

Infirmaries In large tion with

cities

an open

where a hospital for the care of advanced cases has a working connecsanatorium in the country for the cure of incipient consumption, it

air

has been found that there

more

is

or less interchange of cases between the

two

institutions.

Patients taken into the hospital for advanced cases, to be cared for until they die, often im-

prove under nursing, good food and hygienic surroundings, and are then sent to the country, while others fail

who go

to the sanatorium for the cure seemingly only incipient cases, gradually

in strength or develop acute

remain there until they

symptoms and have

to be sent to the city hospital

and

die.

This peculiarity of the disease has created a need for buildings on sanatorium grounds, where patients who have come to be cured, but develop symptoms of advanced disease, can be housed and cared for until they improve or are discharged. There is also a need in all large sanatoria for a building

where patients taking the open

air

they develop some other acute disease which requires nursing.

treatment can be placed

if

Buildings used for these

purposes are called infirmaries, and combine the structural details of both the general hospital

and the large open

air buildings of the

sanatorium.

They

are often constructed as a

complete unit and administered separately from the other sanatorium buildings.

INIany

them have a dining room, kitchen and quarters for nurses and servants, who do not have any relationship except an official of

one, with other parts of the institution.

In some instances the infirmary building

houses the medical department and

may

be designated the medical building, as illustrated in this section,

dack Cottage and

by the Adiron-

Edward Sanatorium

infirmaries.

These buildings should be heated and constructed of good material, fire-proof if possible, and with all the sanitary precautions taken to

make

a general hospital

comfortable and convenient, and the material

used in them from becoming infected.

Reception Hospitals

A

reception hospital

pro^•ide a place for the

is

intended to

temporary care

of

cases arriving at institutions for the treat-

pulmonary tuberculosis and where

ment

of

these

new

patients

may

No. 47.— Isolation Hospital, Paterson, N. J. Charles E. White. Architect. \'ie\v of THE CORXER OF OXE OF THE PoRCHES SHOWING Method of Heating for Advanced Cases by

be under observa-

tion in order that the physicians can classify

the stage of their disease and learn the idiosyncrasies of

each

case

under fresh

(See illustration 52 for further STE.4M Pipes. description of this institution.)

air

93

Section

IV

treatment before placing them in open shacks and cottages. Reception hospitals are same purposes as infirmaries and should be constructed in the same

also used for the

manner and with

as

good material as

is

used for advanced case buildings.

EXAMPLES OF HOSPITALS FOR ADVANCED CASES Riverside Hospital,

New York

City,

The Concrete Pavilion

building is constructed of reinforced concrete, iii feet long

This

by

(Illustration 48).

18 feet wide through

and was designed on the lines of a lean-to four stories high a sitting room between two open-air pavilions with dressing, toilet and bath rooms in a rear extension. It is used for advanced cases and arranged so that the front can be thrown entirely open converting the wards on each story into open-air porches. This building was designed to be used interchangeably for the care of cases of tuberculosis and the contagious disthe wards,

;

eases (measles, scarlet fever, etc.), according to the needs of the service.

The wings on the first floor are 36 feet long by 16 feet wide, with an apartment between them 29 feet long by 15 feet wide used as a dining room. The wards on the second and third floors are 41 feet long by 16 feet deep, with a sitting room 18 feet wide by 21 feet deep in the centre. The fourth story or roof garden is divided into two open wards and one open-air sitting room of the same dimensions as those below. The Riverside Hospital for advanced tuberculous patients is on North Brother Island at the upper end of the East River near Long Island Sound. The institution is The air is pure and so far as climatic conditions are concerned in an isolated position. open air building. The authorities feel that the advanced sheltered is an ideal site for a in a manner that will give them every chance of a housed patients sent there should be and these concrete pavilions are being built as an experiment with the hope that some the cases will respond to the treatment and that all the patients housed in these structures

cure, of

will

do better than they did in the old block type of hospital. This building has a capacity of seventy-eight patients and the estimated cost

is

$40,000.

Jewish Hospital for Consumptives, Reisterstown, Md., Advanced Case Pavilion ^Illustrations 49 and 50). The building is 153 feet long including the side porches, and 57 feet deep through the wings; located on the southern slope of a hill, with a basement above ground on the south side. The material used for the foundations and walls of the basement is native stone, for the first story pressed brick, and the second The interior walls and ceilings are of hard plaster with story rough stucco on metal lath. round corners, covered with non-absorbent washable paint, and finished in plain wood surfaces; the floors are of hard wood dressed with oil. The basement contains the dining room 51 feet wide by 30 feet deep, kitchen 23 feet wide by 28 feet deep, serving room, pantry, fuel storage, laundry, sterilizing and drying rooms. There are sixteen single rooms in the building 10 feet wide by 12 feet deep and 10 feet high, and two wards of four beds, each patient being allotted twelve hundred cubic The sleeping porches in the centre of the building are 8^ feet long by 1 feet of air space. feet wide, protected at each end by the extension of the building, twelve feet to the south. The reception room, 21 feet wide by 23 feet long, and the superintendent's quarters, which 94

Hospitals for

Advanced Cases,

Infirmaries and Reception Hospitals

llu

SsaoND

i

I

I

uli

£ Tv/AD flooE Pzyif/

J}/K£X^/J>£ .'/aSP/TAL

No. 48.— Riverside Hospital, New York City. Designed by Dr. Hermann M. Biggs. Westervelt & Austin, Architects. Concrete Pavilion for Advanced Cases. Front Elevation and Floor Plans. Capacity, 78 Patients. Estimated Cost, $40,000. 95

Section consist of office, sleeping room,

The main entrance to

all

is

on the

bath and

first floor

IV

toilet,

are on the

the east wing.

and leads by a stairway

the floors.

The

rear extensions

wall of the corridor

and 25

at

the

ends of the building are

feet wide,

and contain the

service stairways, lockers, diet kitchens, patients' toilets

The

first floor in

in the centre of the building,

28

feet

deep from the

and baths, and baths, drug and supply rooms. nurses' rooms, toilets

centres of both the upper floors are used for housing the patients.

Their sitting rooms,

porches and sleeping apartments face the south and are protected from the north winds

by a heated corridor extending the entire length of the building. All the rooms are heated by direct steam radiators, lighted by electricity, provided with electric bed ^l-armers, have electric connections with the nurses' apartments and are screened against insects. The doors open on to a porch in front and into a corridor at the rear six feet wide, and over them are movable transoms giving cross-ventilation above the beds. The doorways are wide and have no sills, so that the beds can be rolled through either end and moved from one floor to another on the elevator. The building was erected for advanced cases with the idea of obtaining unobstructed cross-ventilation from every direction without mechanical means, and of giving most of the patients an individual room with porch space equal to its floor area. The building has a capacity of twenty-four beds and cost S30.000.

No. 49.

— Jewish OK \'ir:\v

Hospital for Consumptives, Reisterstown, Md. i'A\ iliux i-ur Advanced Cases. Front and Rear Elevations. Capacity, 24 Patients. Cost, $30,000. 96

Hospitals for Advanced Cases, Infirmaries and Reception Hospitals

&A.^t/AE/^T

No.

50.

— Jewish

PLAn

Hospital for Consumptives, Reisterstown, Floor Plans. Capacity, 24 Patients.

Md.

Paviliox for Advanced Cases.

Cost, 830,000.

Indiana State Hospital, Rockville, Ind., Ward Building (Illustration 51). one of two similar buildings connected \\ith the administration building illustrated in Section II. It is 295 feet long, 59 feet deep through the centre and 25 feet deep through the wings, two stories without a basement, and of frame construction on a concrete foundation. On each side of the central section the w'ngs are divided into a row of single rooms This

is

by 10 feet deep, with a sleeping porch 10 feet wide and 100 feet long in the and a corridor five feet wide in the rear. In the centre is a sun parlor 30 feet wide by 33 feet deep, a nurses' room 14 feet wide by 20 feet deep, a diet kitchen 13 feet wide by 13 At the outer ends are the patients' toilets, baths and feet deep and a serving room. 10 feet wide

front,

lavatories.

The

corridor in the rear of the

passageway with a

rooms on both

stories is

connected by an enclosed

hall in the administration building, in order that the patients

may be

Under these passageways are tunnels connecting the pavilions, administration building and power house, and carrying the service pipes, lighting wires and heating mains. The rooms on the first floor are protected on the front by double glass doors opening out on to the sleeping porches, through which the beds can be run when desired. Those

sheltered in

7

bad weather while going

to

and from

97

their meals.

Section

No.

IV



51. Indiana State Hospital, Rockville, Ind. Waed Building. Brubaker & Stern, Architects. View of Front Elevation and Floor Plan; Both Floors Alike. Capacity, 40 Patients. Estimated Cost, $30,000. (See illustrations 7, 26 and 46 for further description of this institution.)

on the second

floor are

equipped with an arrangement called the "Indiana Convertible

Sleeper," described on pages 91

The

and

92.

building has a capacity for forty patients,

all

housed in single rooms, at an

esti-

mated

cost of $30,000.

This

Isolation Hospital, Paterson, N. J., Tuberculosis Pavilion (Illustration 52). a two story building constructed of reinforced concrete, with concrete floors, and is

is

fire-proof

throughout with the exception of the window frames and the framework

porches.

It

is

Paterson Isolation Hospital, from which

The

of the

a pavilion to house advanced tuberculous patients in connection with the it is

administered.

building, not including the porch,

is

56 feet deep

by

27 feet wide.

The

floor

plans of both stories are alike, divided into a ward 24 feet wide by 25 feet deep, two private

rooms 10

feet

wide and 12 feet long, a linen room 6 feet wide by 10 feet long, a diet kitchen

sitting room 8 feet wide by 10 feet long, containing and stationary wash-stand, and a lavatory 10 feet by 10 feet, containing bath, wash-basins and toilet for the patients. The porches extend on both stories along the entire front, 12 feet wide by 38 feet long, and on the south side of the building 11 feet wide by 42 feet long, floored with con7 feet

wide by 10 feet long, and a nurses'

a private

toilet

Hospitals for Crete, enclosed

Advanced

with swinging glass and sash windows and heated by steam pipes which

extend along their outer edges.

The include tion,

its

Cases, Infirmaries and Reception Hospitals

(See illustration No. 41.)

and cost Si 2,096, but this does not proportion of the expense of the power house or the enclosed corridor construcpavilion has a capacity of twenty-four beds

which connects

United

Dormitory

it

with the administration building.

States

Army General

(Illustration 53).

This

is

Hospital,

walls of frame with brick veneer externally.

FIRST AND SECOND

FLOOR

No.

52.

PLANS

The

roof

is

shingled and the interior walls

STORY

— Isolation

Hospital, Paterson, N. J. Charles E. White, Architect. Pavilion for View of Front and Side Elevation. Floor Plan; Both Floors are Capacity, 24 Patients. Cost, $12,096. (See illustration 47 for further description of this

Advaxced Cases. Alike.

Fort Bayard, N. M., Officers'

a single story building with a stone foundation and

institution.)

99

Section

IV

The building is 147 feet long by 34 feet wide, heated by a hot water system and lighted by electricity. It is divided down the centre by a corridor six feet six inches wide, and has eighteen rooms for patients, twelve on the south side and six on the north side, all of the same dimensions, 11 feet wide by 13 feet deep. These rooms open upon covered sleeping porches about ten feet wide, with doorways made wide enough so that There is also an office 11 feet wide by 13 feet long, the beds can be rolled through them. an attendants' room, baths and toilets. The capacity is eighteen patients and the building plastered.

cost $18,534.

United States Army General Hospital, Fort Bayard, N. M., Enlisted Men's 2 (Illustrations 54 and 55). Ward Two is a single story structure, constructed of concrete with "pebble-dash" finish and built around a central court or "patio" 59 feet wide by 79 feet long. The building including the court covers ground space 100 feet wide by

Ward No.

130 feet long.

Platforms or porches ten feet wide extend around the interior of the building

on the sides of the court where the beds and sun by canvas curtains on rollers.

of the patients are placed

At the corners

and protected from rooms 23

of the building are

rain feet

No. 53.— United States Army General Hospital, Fort Bayard, N. M. Officers' Quarters. View OF Front and Side Elen'atkjn and Floor Plan. Capacity, 18 Patients. Cost, $18,534.

Hospitals for Advanced Cases, Infirmaries and Reception Hospitals

HATnOffM

lO/?CS3MC fflU

No. 54.— United States Army General Hospital, Fort Bayard, N. M. Designed by Major George E. Bushnell. Enlisted Men's Ward No. 2. View of Front and Side Elevation AND Floor Plan. Capacity, 32 Patients. Estimated Cost, $25,000.

Section

No.

55.

— United

States

Army General

IV

Hospital, Fort Bayard, N.

M.

\"iew or Inxer

Court

Showing Sleeping Porches.

wide by 23 feet deep, used for offices, lavatories, storage and attendants. These rooms are connected by long narrow apartments 14 feet wide by 68 feet long, on two sides of the building,

and 14

feet

wide by 50

feet long

on the others, intended as dressing rooms rather

than sleeping rooms, but used for the latter purpose in stormy weather. Numerous French windows open from the dressing rooms on to the porches facing the court and also

upon porches constructed on the outside of the building. This arrangement permits the beds and reclining chairs to be moved freely on to a platform having any exposure desired and gives the patients an opportunity to seek or avoid the sun at pleasure. It is reported to be very satisfactory and that two other buildings of the same design will be constructed. This type of building is especially good for dry, tropical countries, but can be used for It patients' quarters in any climate if the porches are protected by permanent roofs. has a capacity for forty patients and the estimated cost is $15,000. Lakeville

Case P.wiliox up

as

Tuberculosis (Illustration

State Hospital

a

for

Hospital,

56).

Middleboro,

This structure

housing

all

is

classes

of

one

of

cases.

Mass., The Advanced a group It

is

of buildings

and stone

forty-eight feet long, of frame construction, placed on a stone foundation, piers.

It consists of a central section 36 feet

extension),

two twenty-bed wards 64

feet long

put

two hundred and

wide by 62 feet deep (including the rear

by 20

feet wide,

and two twelve-bed open

air pavilions built in the form of a right angle, extending forty feet from the outer ends of

the wards. floor is a

The

central section of the building has

two

stories

and a

cellar.

sun parlor, three small wards, a diet kitchen, treatment room,

On

toilets

the

first

and baths.

Hospitals for The second cellar is of

The

story

Advanced is

Cases, Infirmaries and Reception Hospitals

36 feet wide by 50 feet deep and

about the same

and

size

is

used for lockers,

is

divided into nine rooms.

toilet

The

rooms and storage purposes.

wards are an objection to using the plan for this building, but they could be and it is easy to administer. It would also be improved by dividing the locker rooms, bath rooms, and toilets on the main floor into two sections, providing a nurses' office, one or two more pri\'ate rooms, a larger sun room, and larger wards, gi\dng more large

divided,

air

space to each patient.

The

building has a capacity for seventy patients, and cost $17,600.

Boston Consumptives Hospital, Boston, Mass., Cottage tor Advanced Cases

This

(Illustration 57;.

foundation and concrete first

quality maple.

The

is

a frame building with a shingle roof, placed

piers.

building

The is

interior walls are plastered

an assembly room 22

feet

on a concrete floors are of

144 feet long and 25 feet through the wards, including

the porches, with a rear extension 45 feet deep and 28 feet is

and the

mde.

At the

front in the centre

wide by 24 feet deep and in the rear extension an emergency

miiZAii^

No. 56.— Lakeville Tuberculosis Hospital, Middleboro, Mass. Johx A. Fox. Architect. Pavilion FOR Advanced Cases. \'ie\v of Front and Side Elevation and Floor Plan. Capacity, 70 Beds.

Cost, $17,600. 103

Section

IV

A, Assembly

Room.

B,

Ward.

C,

Locker-room.

D, Toilet-room. E, Nurses' Office. F,

Emergency Ward.

G, Veranda.

iQaaflflMnnanB B

No. 57.

— Boston

^

A

lidddflflOtiDDtl *^

B

Consumptives Hospital, Mattapan, Mass. Maginnis, Walsh & Sullh'an, Cottage Waed for Ad\'anced Cases. View of Front Elevation and Floor Plan. Capacity, 24 Patients. Cost, $14,000.

Aechitects.

feet wide by 11 feet deep, two dressing rooms by 21 feet deep, each containing twelve lockers 3 feet wide and 2^ feet deep, and two toilet rooms 27 feet wide by 13 feet deep, furnished with six lavatories, four toilets, two baths and two showers. The wards face the south, are 14 feet wide by 16 feet long, and each contains a single row of twelve beds, with a veranda in their front 10 feet wide by 60 feet long, separated from the wards by a glass partition made up of triple hung windows

ward

of

two beds and a nurses' room, both 10

14 feet wide

104

I

Hospitals for

Advanced Cases,

extending from the roof to the

floor.

Infirmaries and Reception Hospitals

Along the north

side of the

wards

is

a row of windows

which give cross-ventilation. It has front, as

cases

and

hung windows on the advanced heated by steam, lighted by electricity,

been suggested that doors be substituted

they are rather heavy and hard to move. is

very satisfactory for the purpose.

It is

for the triple

This ward

is

for slightly

has a capacity for twenty-six patients, and cost, including equipment, $15,000.

EXAMPLES OF INFIRMARIES AND RECEPTION HOSPITALS Maine State Sanatorium, Hebron, Me., The Infirmary This

is

a frame structure, on a stone foundation.

(Illustration

Under the left wing the ground

58).

falls off to

No. 58.—Maine State Sanatorium, Hebron, Me. T. C. Stevens and J. H. Stevens, Architects. Infirmary. View of Front Elevation and Floor Plan. Capacity, 30 Patients. Estimated (See illustrations 11 and 23 for further description of this institution.) Cost, $30,000. _

105

Section

IV

such an extent that an open ward was constructed in the basement, providing an arrange-

on the floor above. The building consists of a centre section, two two wings and a rear extension. The front of the building is in the form of an acute angle and has a porch running its entire length, eleven feet wide. The wings are 32 feet wide by 61 feet long, divided into nine single rooms each 7 feet \\dde by 11 feet deep, ^^'ith a closet 3 feet wide by 2 feet deep, and a passageway or corridor four feet wide in their rear. It should be noted that the rooms are ventilated by transoms opening above the roof of the porch through which sunlight is obtained and that the arrangement of Behind the corridor in each wing closets in connection with the sleeping rooms is unusual. containing lavatories, toilet and baths. an extension long feet deep, is by 7 27 feet the rear extension, section building, including is 30 feet wide The central of the

ment

similar to that

stories high,

Designed by Dr. Hermann M. Biggs. J. D. Burt, Architect. \\'omen's Infirmary. \'iews of Front and Rear Elevations. Capacity, 24 Patients. Estimated Cost S5.000. fSee illustrations 14, 28, 85, 94 and loi for further descriptions

No. 59.— Municipal Sanatorium, Otisville, N. Y.

of this institution.;

106

Hospitals for

Advanced Cases,

Infirmaries

^/^ V?

No.

60.

7-

and Reception Hospitals

rxoa

—Municipal Sanatorium, Otisville, N. Y.

Architect.

Women's Intirmary.

Designed by Dr. Hermann M. Biggs. J. D. Burt, Floor Plans. Capacity, 24 Patients. Estimated Cost, $5,000.

by 82 angles

feet deep, divided

by the

through the centre by a hall four feet wide, which

corridor leading to the wings.

private patients, 11 feet wide

by

other one private room, a dining

wide by 13 feet deep.

13 feet deep,

room

The dimensions

On

is

cut at right

one side of the hall are two rooms, for

an operating and preparation room; on the by iS feet deep, and a kitchen 16 feet

16 feet wide

of the extension are only approximate, as the rear

and sides of the building are broken and project in order to give space for the dining room and kitchen. This building is connected by a tunnel with the administration building and is heated from the central plant. The capacity is for thirty patients at an estimated cost of $20,000.

Municipal Sanatorium, Otisville, N. Y., Women's Infirmary (Illustrations This building is a two story frame structure which rests on a stone foundation and stone piers, with a basement under the central section 25 feet wide by 29 feet deep. The exterior of the building is covered with shingles, stained green, with cream colored trimmings and the roof is also of shingles stained a Tuscan red. It is 88 feet long by 16 feet wide through the wards, and 28 feet through the centre, and consists of a centre section and two wings. The first floor is divided into two open wards for six patients each, 16 feet wide by 27 feet long, a sitting room 24 feet wide by 14 feet deep, a locker and dressing 59 and 6oj.

107

Section

IV

,^

«y

UBS i' ^l^kijkW*

No.

A

''

— Eudowood

Infirmary Sanatorium, Towson, Md. Archer & Allex, Architects. the Front .and Rear Elevations. Floor Plans. Capacity, 30 Patients. Estimated Cost, $30,000. (See illustrations 22 and 83 for further description of thus institution.) 6i.

Building.

room

\'ie\vs of

II feet wide

by

13 feet deep, baths, toilets

and attendant's room

11 feet

wide by 14

feet deep.

The second

two small open wards iS feet wide by 16 feet deep, two by 14 feet deep, a small hall four feet wide, two dressing rooms with lockers 10 feet wide by 12 feet deep, diet kitchen, 9 feet wide by 9 feet deep, and an enclosed infirmary ward 24 feet wide by 14 feet deep, situated over the sitting room in the sitting

rooms

floor contains

12 feet wide

centre of the building with a capacity of four patients.

The

building has good

modern plumbing throughout and 108

is

heated through direct

Advanced

Hospitals for

Cases, Infirmaries and Reception Hospitals

by a steam heating plant

basement which also contains a water tank for is no stairway connecting the two iioors, the upper story being reached by a platform running from a steep side hill in the rear of The front windows are all arranged so that both sashes can slide into pockets, the building. radiators

supplying hot water for

in the

There

toilet purposes.

By this means the infirmary can be changed when The capacity is twenty-four beds, and the cost of construction

leaving the openings entirely free. desirable into

an open ward.

was S5,ooo.

Eudowood Sanatorium, Towson, Md., Infirmary Building This

is

(Illustration 6i).

a frame structure, covered externally with shingles, resting on a stone foundation

It is 192 feet long by 25 feet wide, through the wards, and consists of a two wings and three rear extensions. The centre of the building is two stories with a cellar and is designed after the Colonial style of southern architecture, 36 feet wide by 46 feet deep including the porch, but not the rear extension, which is 17 feet

and stone

piers.

central section,

wide by 35 feet deep. On the front is a sitting room 35 feet wide by 16 feet deep and behind it a hall four feet wide uniting the two wings, an examining room, a linen closet and a storage

The

room.

dining

room

15 feet wide

by

and and a kitchen 15 The cellar contains rooms for the heating plant and feet wide by 14 feet deep behind it. storage and the second story four bedrooms, closets, baths, toilets and a sleeping porch II feet wide by 34 feet long for the use of the nurses. The wings including the private rooms and porches at the ends are 98 feet long by 25 feet wide, and are divided into two wards for six patients each, 31 feet long by 13 feet deep, with a porch in their front 10 feet wide by 78 feet long, three private rooms at the outer ends each 8 feet wide by 10 feet deep, a private porch 24 feet wide by 8 feet deep, and in the rear an extension 16 feet wide by 21 feet deep, containing lockers, toilets and baths, and a dressing room. This building is considered a model for a good infirmary at a large sanatorium, well provided with other buildings. Twenty-four patients are housed in small wards; six in private rooms, and all having private alcoves in the dressing is

21 feet deep, partly in the central section

partly in the rear extension, with a pantry 15 feet wide

The

room.

building

is

a

complete unit,

as

by 10

there

are

feet deep,

comfortable

quarters

pro-

vided for the nurses and attendants, a dining room, kitchen, and other necessary apartments.

The

plans are worth careful study, and the private rooms at the ends of the

wings, with a private porch which cannot be overlooked from the

be noted.

The capacity

is

thirty beds

Edward Sanatorium, (Illustration 62).

This

and roofed with

shingles.

unfinished attic lighted

is

and the

Naperville,

main

buildings, should

cost $30,000.

111.,

Infirmary and Medical Building

a two story frame structure, on a stone foundation, painted white It

is

70 feet long by 34 feet wide and has a basement and an

by dormer windows.

The basement

contains a disinfecting

room

wide by 14 feet long, a disinfecting plant for sputum cups, coal storage 24 feet long by 14 feet wide, a carpenter shop 9 feet wide by 16 feet long, a mortuary 6 feet wide by 7 feet long, a dressing room 10 feet wide by 12 feet long, with two shower baths, and an engine II feet

room

16 feet wide

The

by

and hot water tank. by a hall and contains a reception room wide by 12 feet long, a dressing room 6 feet wide by 11 feet long, a diet kitchen 7 feet wide

17 feet long for the. heating plant,

first floor is

divided

down

the centre

and superintendent's office, both 11 feet wide by 10 feet long, a drug room 10 feet by II feet long, and two dressing rooms and lockers.

for the infirmary patients, with toilets, baths

109

Section IV

HASEWb-MF

HUM



No. 62. Edward Sanatorium, Naperville, 111. Designed by Dr. Theodore B. Sachs. W. A. Otis AND Edward H. Clark, Architects. Infirmary and Medical Building. View of Front and Side Elevations antd Floor Plans. Capacity, 12 Patients. Cost, $21,435. (See illustrations 82 and 88 for further description of this institution.)

The second story is also divided by a hall running through the centre of the building and arranged with rooms for the superintendent, physician and nurses, and two dressing rooms with toilets, baths and lockers. The infirmary is housed on two large porches 31 feet wide by 18 feet deep, one on the first and the other on the second floor, facing the south and protected on the west by windows, on the north by the wall of the building and on the south and east by canvas curtains. Each porch accommodates six patients, the lower for men and the upper for women. The building was carefully designed and

Hospitals for

Advanced

Cases, Infirmaries and Reception Hospitals

simply finished with round corners, smooth surfaces, walls.

It

tile

and cement

floors

and enameled

heated by steam, well ventilated and cost $21,435.

is

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Infirmary and Medical Building (Illustration 63). This building consists of a basement and two stories with walls of the foundation and

The second

story

first

story constructed of native stone two feet thick.

frame with a shingled

exterior, extra insulation against cold having been obtained by using two layers of paper and siding between the shingles and interior

finish,

which

is

is

of

plaster

on wood

Its peculiar right-angle

lath.

shape

is

due to the position

of the site, as there

was not

room enough on the land to place a straight structure. The width of the front is twentytwo feet at the angle, and the length of each side on the front is fifty-three feet and on the rear forty-six feet. The basement contains the heating plant, and a store room used in connection

On to a

the

with the laboratory. first floor

are eight patients'

rooms 9

feet

porch 10 feet wide by 60 feet long, with a corridor

1

%

^MWKF

f^fFi

II r

wide by 13 feet deep, opening on wide in the rear; a nurses'

five feet

iifniP'li m^^^mA^^



No. 63. Adirondack Cottage Sanitarium, Saranac Lake, N. Y. Scopes & Feustmann, Architects. Infirmary and AIedical Building. View of Front and Side Elevations and Floor Plans. Capacity, 10 Patients. Cost, $26,000. (See frontispiece and illustrations 13, 98, 104 and 109 for further description of this institution.)

Section bedroom

9 feet wide

by

13 feet deep, a sitting

IV room

13 feet wide

nurses' ofi&ce in the angle 10 feet wide at the widest point

windows are mirrors

of this office next to the

room

in the centre of the lockers, baths

and

is

and 13

and a

13 feet deep

In the corners

so arranged that the nurse sitting at a desk

able to overlook both porches.

toilets, a hall,

by

feet deep.

In the rear

of the corridor are

stairway and the main entrance.

The second floor is divided into a laboratory 27 feet long by 16 feet wide, a treatment room 10 feet wide by 13 feet deep, an examination room 13 feet wide by 17 feet deep, a throat room S feet wide by 9 feet deep, a patients' waiting room 11 feet wide by iS feet deep, a drug room 10 feet wide by 13 feet deep, an .v-ray room 9 feet wide by 13 feet deep, a doctor's office 14 feet wide by 15 feet deep, a statistician's office 12 feet wide by 15 feet deep and two porches 11 feet wide by 20 feet deep, on which the medical staff work on pleasant days.

In order to economize on the cost of construction, this structure was made to combine the purposes of an infirmary, reception hospital and medical building. first

arriving at the sanitarium are cared for on the

for the is

work

of the medical

and laboratory

staff.

first floor

One

All patients

while the second floor

is

when used

interesting feature of the building

the arrangement of the transoms in the patients' rooms over the roof of the porch.

This overcomes the disad^'antage a continuous porch,

The

but

it

of shutting

out the sunlight when rooms are flanked by

can only be planned for when patients are housed on one

floor.

building has a capacity for ten patients and cost $26,000.

Maryland (Illustration 64 j.

State

Sanatorium,

This building

is

of

Sabillasville,

Md.,

Infirmary

Building

frame construction, placed on a stone foundation, and

'Tl-7-T-Tl-T-Tl-l t«^f—

No. 64. Maryland State Sanatoriiun, Sabillasville, Md. Wyatt & Nolting, Architects. Infirmary Building. View of Front Elevation, and Floor Plan. Capacity, 20 Patients. Estimated Cost, Si8,ooo. (See illustrations 3 and 75 for further description of this institution.)

Hospitals for

Advanced Cases,

Infirmaries and Reception Hospitals



No. 65. Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Associated Architects. Infirmary Building. View of Front Elevation, and Floor Plan. Capacity, 24 Patients. Cost, $18,000. (See illustrations 4 and 78 for further description of this institution.)

stone piers, and covered on the exterior with shingles.

It

is

designed on the same lines

as the lean-tos for housing the incipient patients at this institution. It consists of a central section,

195 feet long

on the

room

25 feet

sitting

two wings and three small rear extensions, and

length of the building and in

its

containing a nurses' room 9 feet wide

by

the

full

long, feet

and a

store

is

The central section is 28 feet wide by 32 feet deep, containing a wide by 18 feet deep and two small linen closets. The corridor runs

front.

room

8 feet

rear are three extensions, the one in the centre 9 feet long, a diet kitchen 9 feet wide

wide by 9 feet long.

deep by 31 feet wide and contain the

toilets

by 16

feet

Those in the rear of the wings are 36 and baths. The capacity is twenty

patients at an estimated cost of $15,000.

Georgia State Sanatorium, Alto, Ga., The Infirmary Building 65).

This

is

(Illustration

a one story building with a basement, of frame construction, placed on a

foundation of local stone 18 inches thick.

It is covered

with shingles on the outside,

having one thickness of siding and building paper over the studs and plastered on the inside over wood lath. It is 150 feet long by 25 feet through the ends, and 37 feet

wide through the centre which 8

is

divided by a large lounging hall 12 feet wide by 35 feet 113

Section long.

This hall

is

cut at a right-angle

by

IV

a corridor

7

feet

wide and 92 feet long, uniting

the two wards, which are both 24 feet wide by 29 feet deep and have a capacity of eight There are sleeping porches 10 feet wide by 34 feet long, for six patients patients each. each, at the ends of the building, a porch 12 feet wide

the south, and two porches both 10 feet wide

by 20

by 41

on two patients each, on the

feet long for eight patients

feet long, for

No. 66.— Danvers State Hospital, Hawthorne, Mass. Designed by Dr. F. Page. Pavilion; View OF Front and Side Ele\ation and Floor Plan. Capacity, 16 Patients. Estimated Cost, S6,ooo. 114

Hospitals for Advanced Cases, Infirmaries and Reception Hospitals

tMp \^

Livmc

fx.aorj

^k

F-OKCn

No.



67. Ohio State Sanatorium, Mount Vernon, Ohio. I-". L. Packard, Architect. Reception Hospital. View of Froxt Elevation and Floor Plan. Capacity, 24 P.atients. Estimated Cost, $30,000. (See illustration 77 for further description of this institution.)

north.

In addition to the wards there are

conveniently placed locker rooms,

six private

toilets,

rooms 9

feet

baths, linen closets

wide by 13

and a

feet deep,

diet kitchen.

and

The

was planned so that it could be used as a temporary administration building, The architect easily and economically turned into a well laid-out infirmary. designed the infirmary first and then worked out the arrangement for administrative purstructure

and then

IV

Section

The ward on the east end was converted into a beyond enclosed for a kitchen and pantry, and the north porch enclosed for a staff dining room. The ward on the west end was cut down to a capacity for six patients and the remaining space converted into sleeping rooms for two nurses. The balance of the building as constructed will not be changed. When converted into an infirmary it will have a capacity of twenty-four patients. The cost of construction was $iS,ooo. poses for which dining

now being

it is

room and the

used.

sleeping porch

Danvers State Hospital, Hawthorne, Mass., Tuberculosis Pavilion tration 66).

This pkvilion was erected to house insane tuberculous patients, but

arranged for use as a reception cottage feet

wide by 32

feet deep,

if

small observation wards are desired.

The

a large, well screened porch 11 feet wide

wide by 20

feet deep,

by 60

At the

feet deep, opening into a dining

room is an The arrangement of

rear of the dining

attendants' room, pantry, toilet and bath. it is

and the glass in the at an estimated cost

structurally a part of the building

The

capacity

is

is

of

pavilion contains

room

18

with two small wards 20 feet wide by 20 feet deep, for eight

patients each, on either side.

as

well

It is 60

with a rear extension 35 feet wide by 18 feet deep and

frame construction, covered with shingles and heated with steam. feet

(Illusis

sixteen patients,

extension containing the

roof

the porch is

is

interesting

an unusual feature.

of $6,000.

Ohio State Sanatorium, Mt. Vernon, Ohio, Reception Hospital

(Illustration

on a concrete foundation, with This building is two 67). through the wings. Both trimmings, and tile roof, feet long and feet white stone a 147 37 central section, two wings and a same general floor plan, consisting of a stories have the stories high, constructed of brick,

rear extension.

In the centre

is

loggia on the front 31 feet wide

a living

by

room

31 feet wide

13 feet deep.

rooms 8 feet wide by 10 feet deep, with a corridor

by

15 feet deep, with a porch or

The wings are divided into five feet

six single

wide at their rear and a porch

by 55 feet long on the front. The rear extension is 32 feet wide by 59 feet deep, divided by a corridor in the centre six feet wide, with rooms on either side used for toilets, baths, storage and attendants. The building has a number of good features. It is well constructed and the patients The arrangement of the passageways, corridors and the are housed in separate rooms. It has a capacity of twenty-four patients' closets are convenient and should be noted. or loggia 12 feet wide

patients at an estimated cost of $20,000.

116

SECTION V Patients' Quarters

— Lean-to Type

of

Building

Section

F^

ii8

V

SECTION V Patients' Quarters

— Lean-to

Type

of Building

is a study of the growth and changes made in the lean-to t}^e of building was first adopted for housing incipient tuberculous patients. The many modificahave tended to increase the capacity rather than to change the form. In some

This section

since tions

it

instances the expansion has been upwards, while in others the porches have been lengthened.

A

building of this design can be cheaply constructed and has proven to be comfortable

and serviceable both when put up in a rough way structed and finished on the interior for advanced

for incipient cases,

and when

well con-

cases.

Origin of the Lean-to

The Herbert

AI.

idea of housing tuberculous patients in lean-tos

King, of Loomis Sanatorium.

lean-to camp, which

is

He

was

first

suggested by Dr.

took as his model the old-time Adirondack

usually built of a framework of poles covered with bark, and de-

scribes his first building as a shed with

an overhanging

roof,

constructed to be opened or closed as occasion demands.

open in

front,

with the ends

In the back wall were three

openings in which were placed stationary slat blinds, intended to increase the circulation of air, floor

but which produced too direct a draught for use in winter.

space 12 feet wide

by 40

feet long, giving

room

The

building had a

for eight 30-inch beds,

and was con-

structed of plain lumber neither painted nor stained on the interior and covered externally

In order to make

it serviceable for the winter it was necessary to proroom near at hand. This was obtained by an addition placed directly behind the lean-to and fitted with toilets and wash basins and heated by a stove surrounded by a water coil which provided hot water for toilet purposes. Later the design for this simple structure was modified, and a larger and more This consists of two lean-tos placed end to end, somewhat elaborate building constructed. wider than the original, and connected by a sitting room for use in bad weather, with a double locker and dressing room directly back of it in an extension. The advantage obtained by this impro\'ement over the first building was ample space for reclining chairs at the foot of the beds, protected from the weather, a warm sitting room and a larger dressing

with cedar shingles.

vide a heated dressing

apartment. In designing and constructing lean-tos for housing incipient patients the following points should be considered.

Material Shall the lean-to be constructed with material that will make a fairly permanent and comfortable structure? It would seem as if the funds available must settle this question, for good results are obtained from the open-air treatment in cheap buildings, although some of them are only shacks without plumbing or heating arrangements, where the patients use the old style wash-bowl and pitcher, or go to a small central building 119

V

Section for

washing,

toilet,

and bathing

tuberculosis, patients usually

well

if

toilet

facihties.

During the early stages

of

pulmonary

stand the exposure to cold weather on the porches very

they have a heated apartment near at hand to which they can go for 'dressing and

purposes and

in

order to get warm.

The

objection

made

to

cheap lean-tos

is

that

they are not substantial, permanent buildings, and cost more to maintain in good order

On the other hand, it is contended that they can be torn on the same lines a number of times for less monej' than it costs to erect a permanent structure which may become out-of-date. There is no doubt that a happy than the more costly structures.

down and

mean

rebuilt

exists

between the extremes

of a shed

with

little in

the

way

of comforts, costing

$50.00 to $75.00 per patient, and some of the elaborate buildings classed as lean-tos which

from $400.00 to^Soo.oo per patient. Lean-tos are usually built of frame construction, consisting of a frame made from timbers to which sheathing is nailed and in turn covered externally with cost

shingles or one of the patent board sidings.

When

well seasoned hard pine timbers are

used for the columns and beams of the porch frame, and planks such as are specified in mill construction placed in the floor and roof, the result

nent building.

The

roof

is

is

a fairly substantial and perma-

usually covered with shingles, but tin, slate,

tile

or one of the

patent roofing materials will give good service.

Floors In the sitting room the material for the floors should be hard wood or well laid and

The latter gives good satisfaction and rugs can be used over it. In the extension and dressing rooms, a flooring should be used which will not be affected by water, such as one of the composition materials in which cement is the predominating element, ordinary cement flooring, tile, terrazzo, or a carefully

seasoned ordinary floor boards, covered with linoleum.



No. 69. Catawba Sanatorium, Catawba, Va. Designed by Dr. Enxiox G. Williams. View of AX Oi'Ex Porch Illistratixg a Method of Construction without Interior Finish, and A Manner of Protecting Porches by Canvas Curtains under the Edge of the Roof Projection. (See illustrations 1 7, 30 and 80 for further description of this institution.)

Patients' Quarters

No.

of Building



North Reading State Sanatorium, North Reading, Mass. John A. Fox, Architect. View OF AN Open Porch, Illustrating a Method of Protecting Porches by Canvas Curtains in

70.

Stormy Weather.

laid

—Lean-to Type

board

(See illustration 87 for further description of this institution.)

covered with battle-ship linoleum or modern cork matting, glued down and

floor

turned up at the base

line.

These

last are durable, noiseless

and non-absorbent.

Finish

The

sitting

narrow boards or metal lath.

room

laid over

Both

interior

can be finished either by sealing the walls and

ceilings

of these

methods are

varnished, or the plaster covered with

oil

satisfactory;

the boards

when used should be

paint.

In the rear extension or dressing rooms hard, smooth plaster over metal lath

good

finish

about

five

with

one or more thicknesses of building paper or by plaster over wood

is

a

and this should be painted and covered with coach varnish, and the walls for feet up from the floor protected by tile, or imitation tile made of metal covered

by enamel. The

finish for the interior of the

economy.

The timbers may be

sealed with boards

left

porches depends upon individual taste and need for

exposed in the rough, planed, painted, stained, or

and varnished.

Excavation Basements and cellars do not afford the most sanitary means of obtaining storage and extra room in hospital buildings, and excavations can be eliminated by raising lean-tos If there is reason to fear off the ground one to three feet on stone, brick or concrete piers. dampness a layer of concrete about three inches thick should be spread upon the ground under the building.

Exposure

The

placing of the building in

its

relation to the points of the

compass

is

important.

Usually the exposure of the porches should be south-east rather than due south in tern-

Section

V

perate climates, for since the lean-to has become popular

it

has been found that the

air in

the porches with direct southern exposure often gets exceedingly hot, and sometimes un-

summer months, causIn hot countries and where the summer temperature hours at a time, lean-tos should have two porches for each group of pa-

bearable during the middle of the day and the early afternoon, in the ing the patients great discomfort.

remains high for

one having a southern and the other a northern exposure.

tients,

Arrangement

of Floor

Plans

plan or designing a new lean-to, care should be taken to have the enough to give space for a storage room, a linen closet, a warming closet in which blankets can be quickly dried and warmed, and large indi\ddual lockers 3 In many of the earlier constructed lean-tos the lockers are feet wide by 3 to 5 feet deep. often not more than 12 inches wide by 12 inches deep, too small to allow any privacy to the indi\ddual. It should now be definitely understood that no building for the housing of incipient patients is complete unless it provides adequate facilities to each person for privacy. The latest lean-to constructed at the Loomis Sanatorium is a good illustration of one method

In selecting a

floor

rear extensions large

of

meeting

this

need with a large locker or a small private dressing room.

The arrangement of patients

of the porches

divide the patients into small units. 8 feet

is

also being modified in order to reduce the

number

Large porches should have partitions erected in order to

housed together.

Two patients in

a small cubicle about 10 feet wide

by

deep seems to be the most satisfactory arrangement.

The

rear walls in

many

tilate a lean-to built in this

about quickly.

At

cases are too low.

This

is

a mistake, as

it is

hard to ven-

manner, and causes the patients discomfort when moving

least eight feet in the clear should

be allowed.

Porch Space

The width of

the

of the floor space

and roof projection should be ample,

lean-to provides the living quarters of

the

patients.

Room

to

as the porch

move about

No. 71.—Virginia State Farm, Richmond, Va. View of Open Porch Illustrating Manner of Pkotectixg Porches by Canvas Curtains Placed between Pillars, a Few Feet Back from the Line of the Roof Projection.

Patients' Quarters

—Lean-to Type of Building



Loomis Sanatorium, Liberty, N. Y. View of Chapman Cottage. Sleeping Porch; Illustrating AIethod of Construction and Interior Finish, Using Narrow Floor Boards for Sealing. (See illustrations i, 73, 91 and 108 for further descriptions of this institution.)

No. 72.

freely at the foot of their beds

The depth

of the

porch

is

also

and a

clear space for a reclining chair are necessary.

one of the best protections against storms and high

winds, and should be three times the length of the bed, eighteen feet or more from the rear wall to the front line.

Porch Protection

The

front of the porch

is

usually protected

by canvas

curtains

hung on

rollers,

Japa-

nese matting, glass and sash window^s which can be raised and lowered, or glass doors which

The rear and end openings are generally protected by sliding windows known as the "barn-door" shutter, ordinary glass and sash windows hung either at the side or from the top, or a frame covered with canvas hung on hinges or on a pivot. can be opened and closed.

Ventilation Ventilation

is

one of the most important questions to be considered when planning

air in a room with an open front as it room enclosed by four walls. When cross-ventilation is not obtained the air becomes very bad at the back of the porches. This can be prevented if special care is taken to secure cross currents of air, by windows cut in the side and rear walls, or by openings above the porch roof which remove the foul air close to the ceiling.

lean-tos, for is

in

it is

about as hard to obtain a current of

a

Fixtures and Plumbing

Good

substantial sanitary fixtures should be used in the dressing rooms, allowing one

and one wash-basin to every Plumbing should not be installed toilet

four,

and one shower or bath tub

to every eight patients.

in cheap lean-tos in northern climates unless 123

it is

well

Section

V

^ ^

^^'"

No.

73.

Dr.

— Loomis

Sanatorimn,

Liberty,

Herbert Maxox King. Cost, $1,830.

16 Patients.

N. Y.

View of

(See

Original Improved Lean-to. Designed by Elevation and Floor Plan. Capacity, 108 for further description of this i, 72, 91 and

Front

illustrations

institution.)

protected, or frozen pipes will give visable to

make arrangements

much

trouble during the winter months.

for heating porches to be used

by

It

is

not ad-

incipient patients, as

it

has been found that expensive heating plants provided for this purpose are rarely used.

A comparison of the various floor plans of lean-tos described in

this section

is

shown

in illustration 68.

EXAMPLES OF LEAN-TOS 73).

piers

Loomis Sanatorium, Liberty, N. Y., The Improved King Le.\n-to (Illustration is 100 feet long by 25 feet deep, of frame construction, placed on stone

This building

and covered externally with cedar shingles

left to

w'eather stain.

ture used as the model for the lean-to type of building.

The

sitting

It

is

the original struc-

room

in the centre is

and the dressing room directly back of it is 20 feet wide by 14 feet deep, both being heated by a large stove which also supplies hot water for the baths and hand basins. The interior finish of the centre apartment is hard pine, filled and var20 feet wide

by

25 feet deep,

124

Patients' Quarters

The length

nished.

which depth

of the

porches

is

—Lean-to Type of Building

forty feet, the extent of the roof projection twenty feet,

a great help in keeping out a driving storm.

They are simply and cheaply x 4 timbers supporting the walls and roof are left uncovered, and the smooth surfaces are painted with the exception of the floor, which is laid in the ordinary way except where ex-posed to the rain. In these places it is made of three inch material is

constructed, the

2

with one-half inch spacing between each plank, the edges being slightly rounded, to prevent curling. The building faces the south and during storms the porches are enclosed by

canvas curtains on of sixteen

rollers

which can be raised or lowered.

The

building has a capacity

beds and cost $1,830.

Michigan State Sanatorium, Howell, Mich., Lean-to

(Illustration 74). This placed on stone piers, of frame construction, with a shingled roof, 102 feet long by 25 feet wide through the wards. The rear extension is 25 feet wide by 19 feet deep and the entire floor plan is simflar to the improved King lean-to, but with a different arrange-

building

ment

is

of the lockers, toilets

and baths.

substantially constructed, having glass terrace in front

The

building

is

and sash windows

and more commodious dressing rooms.

also better finished

and more

to enclose the wards, a large

The capacity

is

sixteen beds

and

the cost of construction w^as 84,500.

No. 74.—Michigan State Sanatorium, Howell, Mich. Malcomson, Higixbqtham and Clement, Architects. Leax-to. View of Front Elevation .\nt) Floor Plan. C.vPACiTY, 16 Patients.

Cost, $4,500.

Section

V

Floob Plan of Shacks.



Maryland State Sanatorium, Sabillasville, Md. Wyatt & Nolting, Aechitects. Lean-to. 75. View of Front Elevation, Floor Plan and Cross-section. Capacity, 20 Patients.

No.

Estimated Cost, $7,000.

(See illustrations 3

and 64

for further description of this institution.)

Maryland State Sanatorium, Sabillasville, Md., Lean-to for Incipient Patients (Illustration 75). This building is of frame construction, placed on brick piers, both the roof and exterior walls being covered with shingles and stained. The trimmings around the windows are painted white and the interior sealed with narrow boards and varnished. The structure is 123 feet long by 26 feet deep through the wings, which are divided into a ward for ten patients, 16 feet wide

wide on the

front.

The

rear extension

is

by 50 feet long, with porches ten feet by 30 feet deep and is divided into wide by 22 feet long, arranged to give each

32 feet wide

three apartments, two dressing rooms, 14 feet patient a private dressing alcove containing a set of drawers, and space for hanging clothes,

and a

toilet

room 31

feet

wide by 10 feet deep, containing ample bathing 126

facilities as well

Patients' Quarters

—Lean-to Type of Building

The sitting room between the wards is 22 feet wide by 18 feet same manner as the other parts of the interior. There are ten of these buildings grouped about an administration building, which is described in Section II of this book. They all face the south, every room having light and air from opposite sides, and are alike with the exception of the finish. The wards have a number of windows in the rear and side walls, and are protected in front by large sliding glass and sash frames placed between the columns which can be pushed up and out of the way allowing the wards to become part of the porches. These lean-tos were built to house incipient tuberculous cases, but they are so well planned and constructed that they could be used for advanced cases. Institutions such as small town or county hospitals that need an isolated ward for advanced cases could use this building as a model, and by as toilets

and

lavatories.

deep, finished in the

^

DttJ&n) Mh-Ni

ran MhN I

Partis

i

PancH

H—

ft Mi'

ARCmTECTS. J. &M. Kennedy, View of Front Ele\-ation and Floor Plan. Capacity,

No. 76.—Delaware State Sanatorium, Wilmington, Del. Society Lean-to.

8 Patients.

Estimated Cost, $1,000. 127

Hebrew

Section

V

dividing the wings into single rooms and using the pa\'ilion for a

comparatively small outlay.

of construction

same

interior finish, obtain a substantial

The capacity

is

twenty patients and the cost

about 87,000.

Delaware State Sanatorium, Wilmington, Del., Hebrew Society's Lean-to This is a frame building, on stone piers, covered externally with clapboards and roofed with shingles. 61 feet long by iq feet deep, having a rear extension 14 feet wide by 15 feet deep. This Httle building was erected to house a few patients of both (Illustration 76).

sexes,

and

is

divided into a central sitting

room 14

feet

wide by 18 feet deep, two small

\

No.



Ohio State Sanatorium, Mt. Vernon, Ohio. F. L. Packard, Architect. Lean-to. View 77. OF Front Elevation- and Floor Plan. Capacity, 20 Patients. Estimated Cost, $6,500. (See illustration 67 for further description of this institution.) 128

Patients' Quarters

—Lean-to Type

of Building

o

nmF^nrr

" D ~

_U Jl

^



_[J

il il

^

-pvKMrrmn-

No.

^'iiHi

78. Georgia State Sanatorium, Alto, Ga. Scopes & Feustmann, and Walter W. Judell, Associated Architects. Design for a Leax-to. Floor Plan. Capacity, 16 Patients. Estimated Cost, $2,500. (See illustrations 4 and 65 for further description of this institution.)

feet wide by 23 feet long, for four patients each, one for men and the other for women; with a porch in front S feet wide by 23 feet long, and windows for ventilating the ward above the roof. The rear extension is divided by a solid partition into two dressing rooms, each containing four lockers, a toilet and a bath for the use of the patients. The building has a capacity for eight patients and the estimated cost is $1,000.

wards 10

Georgia State Sanatorium, Alto, Ga., Lean-to, Floor Plan (lUustration

78).

This plan was suggested for the lean-tos to be constructed at the Georgia State Sanatorium,

and was designed

The

of his bed.

on stone wide by

piers,

to give each patient a small private dressing

building to be 103 feet long

by

room

directly in the rear

25 feet deep, constructed of frame placed

divided into two open wards 16 feet wide by 51 feet long, a corridor 4 feet

and sixteen private dressing rooms each 5 feet wide by 3 feet deep. by 17 feet deep and containing This building was planned to have a capacity for sixteen baths, toilets and lavatories. patients, without a central sitting room, and to cost about $2,000.

The

51 feet long,

extension at the rear of the centre to be 23 feet wide

Ohio State Sanatorium, Mt. Vernon, Ohio, Lean-to for Incipient Patients (Illustration 77 j.

This building

is

constructed of frame, placed on concrete piers, with

the exterior covered with shingles, having white trimmings.

The

building

is

148 feet

long and 24 feet through the wings and consists of a central section, two porches

and a rear extension. It was designed after the lean-to type of structure, but has certain deviations from the usual plans which are worth considering, for it supplies all patients with individual dressing alcoves which add greatly to their comfort and are much appreciated.

The

central section contains a living

corridor behind

it

room

25 feet wide

by 18

feet deep,

with a

connecting the two wings or sleeping porches, which are 60 feet long by

The rear extension has a floor plan designed in the shape of a cross (this 24 feet deep. being the unicjue feature of the building) 56 feet deep by 27 feet wide; except through the 9

129

Section

^--. ,

K1

\

)(

-'

^^

^ X )(

'-.

«

i—!::;^

V

HI

^

1

1

S=F ^

No.

79.

— New Haven County State Sanatori-om, Meriden, Conn. Foote & Townsexd, Architects. Front Ele\"atiox axd Floor Plaxs. Note. — There are Two of these Buildixgs,

Leax-to.

EACH Two Stories High, but with Slightly Differext Floor Plaxs. Estimated Cost, $5,000.

Capacity, 40 Patiexts.

is 52 feet wide by 22 feet deep, situated in the centre and extending making a break in the walls which increases the space used for windows. There are also more rooms in the rear extension than are usually planned for in lean-to structures, such as a linen closet, diet kitchen and nurses' room. The building has a capacity for tw-enty patients and the estimated cost is $6,500.

dressing room, which

out on each

side,

130

Patients' Quarters

—Lean-to Type of Building

New Haven County State Sanatorium, Meriden, Conn., Lean-to (Illustration There are two buildings of this design, one at Huntington, known as Building No. 79). 3, and the other at Meriden. They are of frame construction, on stone piers, covered externally and roofed with shingles, two stories high and both having a front elevation practically of the same general appearance, with slight variations in the floor plans. The first and second floors of both buildings are alike and consist of a central section, two wings and a rear extension, one being 98 feet long feet deep; the other 129 feet long

The

by 16 feet deep with a by 15 feet deep with a

rear extension 17 feet wide

rear extension 23 feet wide

by 24 by 15

room in the central section of one is 20 feet deep by 16 feet wide, wide by 15 feet deep. The wings of both consist of a single ward wath a capacity often patients, housed in separate cubicles 8 feet wide by 9 feet deep, for two patients, or for three, 16 feet wide by 9 feet deep. The front of the porches or feet deep.

and

sitting

in the other 19 feet

wards

is

protected

cross-ventilation.

by canvas curtains and the rear walls pierced by windows to give The rear extensions are used as dressing rooms and contain individual

lockers, wash-bowls, toilets

and baths.

of dividing the porches in order to

for forty patients at

These buildings

house patients

an estimated cost

illustrate well the latest

in small units.

They have

methods

a capacity

of $5,000.

Catawba Sanatorium, Catawba, Va., Lean-to

(Illustration

80).

This

is

a

one story frame building, covered with siding and roofed with shingles, on a concrete foundation, 121 feet long by 20 feet deep, through the wings.

The wards

or porches are

^''r"w^?^^^mM

^

I

Warp

No.



80. Catawba Sanatorium, Catawba, Va. Designed by Dr. Ennion G. Williams. Lean-to. View of Front Elevation and Floor Plan. Capacity, 16 Patients. Estimated Cost,

$2,coo.

(See illustrations 17, 30

and 69

for further description of this institution.)

131

Section

V

No. 8i.—Manitoba Sanatorium, Ninette, Manitoba, Canada. Designed by Dr. D. A. Stewart. Leax-to. \'ie\v of Front Elevation and Floor Plan. Cap.^city, 32 Patients. Estimated Cost, $8,000.

(See illustration 25 for further description of this institution.)

by 46 feet long, and the rear extension is 52 feet long by 12 feet deep. There is a sitting room 28 feet wide and 15 feet deep in the centre, with a trunk room 28 feet wide by 8 feet deep back of it. There are two dressing rooms 19 feet wide by 12 feet deep, and a small single bed ward 11 feet wide by 12 feet deep in the rear extension which is very con\'eniently arranged. The building has a capacity of sixteen patients and cost approxi20 feet wide

mately ^2,000.

Manitoba Sanatorium, Ninette, Manitoba, Canada, Lean-to This building

is

(Illustration Si).

placed on a cement foundation and stone piers, two stories high, of frame

construction, externally covered with shingles

94 feet long by 24 feet through the wings.

and trimmed with wood

The 132

central section

is

artistically painted,

20 feet wide

by

22 feet

—Lean-to Type of Building

Patients' Quarters^ and contains a

room furnished with a large fireplace, and a toilet room fitted The wings of the building are 36 feet long by 24 feet deep, divided into open wards 36 feet long by 15 feet deep, with a corridor and three dressing rooms in their rear. Each floor is an independent unit for twelve patients and the building was constructed two stories in height in order to economize in heating, as the winters in Manitoba are very cold. There are two pavilions of the same t^^pe at this institution; the one housing women is shown in the illustration. The other, for men, has a slightly different floor plan, with only one large dressing room in the rear of the sleeping porch. The advantage claimed for this building is that the dressing rooms are closer to the patients and give them more privacy than in the usual lean-to type of structure. The cost of the building including its porportion of the heating plant, installation of plumbing, water supply and sewer connection was $8,000. long,

sitting

with lavatories and baths.

No.



82. Edward Sanatorium, Naperville, 111. W. A. Otis and Edward H. Clark, Architects. Lean-to. View of Front Elevation and Floor Plan. C.-upacity. 10 Patients. Estimated Cost, $1,800. (See illustrations 62 and 88 for further description of this institution.)

133

Section \

Fi

Ai'i-

Of-

III

AiJi'^ii-rniAi'-

J4e^

?uniToyr^

No.

83.

—Eudowood

Sanatorium, Towson,

Md.

OF Front Ele\'ation and Floor Plans. (See illu.strations 22

Edward Sanatorium, is

of

and 61

Le.a.x-to.

View

Estimated Cost, 84,000.

for further description of this institution.)

Naperville,

frame construction, on brick

Archer & Allen. Architects.

Capacity, 8 Patients.

111.,

piers, co\'ered

Lean-to

(Illustration 82).

This building

on the exterior and roofed with

shingles.

64^2 feet long by 16 feet wide, with a rear extension iSVo feet long by 11 feet wide. The front section consists of one ward and the building is illustrated to show the method of protecting its southern exposure and the means used to ventilate through the roof. It is

134

Patients' Quarters

The north

—Lean-to Type

of Building

ward are pierced by eight windows and a door leading into the used as a dressing room and contains lavatories, toilets and lockers

walls of the

extension which

is

for each patient.

It has a capacity of ten patients

and

cost 81,057.

The Eudowood Sanatorium, Towson, Md., Garrett Pavilion or Leax-to (Illustration 83).

This

is

a frame structure raised on brick piers, covered externally wdth

stained shingles and trimmed with white paint. to receive the light

and

air

from

all

sides

It is

an attractive building, arranged

through open spaces, between the columns support-

by canvas curtains stretched on frames and hung on pivots attached to the posts. The front is 56 feet long by 20 feet deep and consists This opens into a rear of one large room used both for sleeping and living purposes. extension 19 feet wide by 24 feet deep, pro\dded "with eight lockers (large enough to be small private dressing rooms 3 feet wide by 5 feet deep), two toilets, two baths and four washThe building has a basins, the whole making a comfortable and convenient apartment. capacity of eight patients and cost 84,000. ing the roof, protected in stormy weather

Iowa State Sanatorium, Oakdale, is

of

la.,

Leax-to

frame construction, covered externally with

(Illustration 84).

siding, roofed

This building

with shingles, and placed

on a stone foundation. In type it belongs to the lean-to group of buildings and was intended but the wings are divided into enclosed rooms with sleeping porches in

for incipient cases,

-^^.^.^..^>l+. No. 84.— Iowa State Sanatorium, Oakdale, la. H. F. Liebbe. Architect. Leax-to, 240 Feet Long. View of Front and Side Elevation ant) Floor Plan. Capacity, 40 Patients. Estimated Cost, S8,ooo.

(See illustrations 24, 29

and 103 135

for further description of this institution.)

Section \ front.

It

is

240 feet long by 24 feet deep.

The veranda

is

twelve feet wide, enclosed with

and mosquitoes. It is claimed that this building has been a success, but that it should have a larger central section and a rear extension so as to give better facilities for toilets, baths and locker rooms. It has a capacity for forty patients and the cost of construction was S8,ooo. wire netting for protection against

flies

The Municipal Sanatorium, This

is

Otisville,

N. Y., The Lean-to

(Illustration 85).

a frame building on stone piers, 105 feet long by 18 feet wide, covered with shingles,

The

stained artistically and trimmed with white.

open porch or ward

dj^vided into three sections

two dressing rooms each 18

entrances from the porch.

There

is

front of the building consists of a long half partitions,

The

the view of the entire porch from either end. feet deep, containing

by

rear extension

feet

which do not obstruct is 42 feet wide by 10

wide by 10 feet deep, with separate

a small cellar excavated under the centre for a furnace

which heats the dressing rooms. The building has no sitting room and should be placed near an amusement pavilion or some other structure having an apartment for this purpose. Its peculiar feature

is

a break in the roof projection at the front in

placed to ventilate the wards or porches.

It

which A^dndows are

has a capacity of eighteen patients at an

estimated cost of S4400.

^ n

o

I

3

-4



i i

n

I'"

I

No. 85. Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Heriiaxn M. Biggs. John B. \'ax Pelt, Architect. Lean-to. \'iew of Front Elev.^tion, and Floor Plan. Capacity, 18 Patients. Estimated Cost, 84,400. (See illustrations 14, 28, 59, 60, 94 and loi for further description of this institution.)

136

Patients' Quarters

—Lean-to Type

of Building



Association Sanatorium, Louisville, Ky. D. X. ^Iurphy & Brothee, Architects. Lean-to. \'iew of Front Elex'atiox and Floor Plan. Capacity, 12 P.a.tients. Estim.a.ted Cost, S2.750. (See illustration 99 for further description of this institution.)

No. 86.

Association Sanatorium, Louisville, Ky., Le.\x-to for 86).

This building

is

on oak posts, and stands on a steep hillside. room 16 feet wide by 16 feet deep, with a dressing room in

struction, placed sitting

12 feet deep, containing bath feet

wide by 16 feet deep.

of its porches.

On

Women

56 feet long by 36 feet wide including the porches,

and

The

the south

toilets.

building

is

On

show the

(Illustration of

frame con-

It consists of a central its

rear 16 feet wide

each side of this section

illustrated to

is

is

by

a dormitory 19

interesting arrangement

one running along the entire front of the building, 9 feet wide by 56 feet long, and on the north are two each 9 feet wide by 19 feet long, one on either side of the dressing rooms. This plan supplies porches with a southern exposure for winter use,

is

and a northern exposure when the weather is too warm for comfort is twelve patients and it cost 82,750.

capacity of the building

137

in

summer.

The

Section

V

North Reading State Sanatorium, North Reading, Mass., The Lean-to :ration 87). exterior

md

is

This building

and roofed with

is

of

frame construction, placed on stone

shingles.

It

is

one hundred and thirty-six

piers,

(Illus-

covered on the

feet along the front,

designed so that both the porches can be overlooked from the sitting room,

rhe length of the wings is fifty-eight feet on the front and sixty-seven feet on The central section :he rear and the width nineteen feet including the veranda. s

ire

sealed

on the

placed

at

the

and the porches are

interior

inner

ends of

the

porches

left

so

as

unfinished. to

utilize

The

locker

the

space

rooms of

the

mgles made where the wings join the centre apartment. The sitting room is 24 feet wide Dy 18 feet deep and ^e two dressing rooms are both 10 feet wide by 18 feet deep, and :ontain shower baths, toilets

and wash-basins.

The

roof of the porch has a break on the

Tont for ventilation purposes, somewhat like that in the roof of the lean-to at Otisville The veranda in front of the sleeping porches also extends in front of the illustration 85). dtting room, and is a feature to be noted, as it adds materially to the floor space which :an be used in good weather.

There are four

vith other buildings for one of the :husetts.

said to

They

new

by the State Commission

are very satisfactory except for the rear walls of

be rather low.

Their capacity

is

up in connection in Massathe porches which are

of these lean-tos, all alike, put

sanatoria built

twenty patients and they cost $3,500 each.

No. 87.— North Reading State Sanatorium, North Reading, Mass. Johx A. Fox, Architect. Lean-to. View of Front Elevation, Floor Plan antd Cross-section. Capacity, 20 Patients. 138

Cost, $3,500.

Patients' Quarters

—Lean-to Type

of Building

/

.

— Edward Sanatorium, Naperville,

AND Edward H. Clark, Architects. C.AP.ACiTY; 6

Patients.

111.

Designed by Dr. Theodore B. Sachs. W. A. Otis View of Front Elevation and Floor Plan.

Lean-to.

Cost, $1,287.

(See illustrations 62

and 82

for further description of this

institution.)

Edward Sanatorium, is

of

Naperville,

111.,

Lean-to

(Illustration 88).

This building

frame construction, placed on cedar posts, covered externally and roofed with cedar

shingles.

It is 52 feet long

by

22 feet

wide and consists

of

an enclosed

sitting

room

15

deep and dressing room 15 feet wide by 12 feet deep, at one end, from which extends out at a right angle a porch or open ward 36 feet wide by 71 feet deep. The

feet

wide by 10

feet

room is plastered and has three large windows breaking up the south wall and two windows and a door leading to the porch. The dressing room is finished in the same manner and contains lockers for each patient, toilets, baths and lavatories. The porch is unfinished, faces the south, has an open front protected in bad weather by canvas curtains, a large door occupying one-half of the east wall, and two large ventilators in the It is illustrated to show the means used to ventilate the porch; the rear and side roof. walls, with the continuous row of windows and the ventilators in the roof, should be noted. The building has a capacity for six beds and cost $1,287. sitting

139

Section

No. 89.

— Iowa

V

State Hospital, Mt. Pleasant, la. H. F. Liebbe, Architect. Lean-to. AND Floor Plan. Capacity, 12 Patients. Estimated Cost, $3,000.

Front

ELEV.A.T10N

Iowa State Hospital, Mount Pleasant, building

is

planned on the

lines of a lean-to,

section which projects to the rear.

It is a

la.,

Lean-to

(Illustration 89).

This

with two wards on either side of a central

one story building

of

frame construction.

The

and finished in oil. The exterior is covered with cedar shingles stained dark brown and trimmed with an ivory color. In the centre of the building is a room 15 feet wide by 19 feet deep, used both as a sitting and dining room, and extending out from each side of it is a porch or open ward

interior walls are sealed with yellow pine

From the wards, on the sides of the central 37 feet long by 14 feet wid* for six patients. room, are passageways 4 feet 6 inches wide by 13 feet long, running back to the dressing room, which is 10 feet wide by 19 feet long, and contains a bath tub, three wash-bowls, a toilet

and a

slop sink.

On

entire front of the building

the inner sides of both halls are lockers for each patient. is

The

open, but fitted between the pillars with sliding sash and glass

windows and frames for screens. The rear walls of the wards also have windows between each bed in order to produce cross-ventilation. The rear extension is 20 feet deep by 30 feet wide, well lighted by windows at every available point, with a cellar excavated under it, containing a hot water heating plant. In the central room is a brick fire-place and an electric oven for reheating the food sent in from the service building, before it is served to the patients. It also has windows on the front above the porch giving sunlight to the 140

Patients' Quarters

room and

—Lean-to Type of Building

ventilation near the ceiling.

The

cost of the building complete, constructed

was $3,000, but the capacity can be enlarged at small expense if desired, by adding rooms at the end of each ward. Attention should be called to the situation of the combination sitting and dining room, the placing of the lockers in halls on its sides and the porch space in front of the central room, used as a vestibule to the to house twelve patients,

wards, as

it is

Rush This

is

a

new arrangement

of a floor plan for the lean-to type of building.

Hospital, Country Branch, Malvern, Pa., Lean-to

(Illustration 90).

a frame building of very cheap construction, placed on concrete piers, and covered

by a composition

two stories high, 53 feet long by 12 feet deep, with a small wide by 18 feet long, enclosed for a dressing room and containing lockers, lavatories and toilets. The balance of the ground floor is used by patients for a lounging and sitting room. The second floor is an open ward housing the beds. The front of the building on both stories is boarded up from the floor four feet, and cross- ventilation is obtained by windows in the rear wall. This structure is practically a portion of the

roofing.

It is

first floor,

7 feet

two story shed facing the south and patients.

is

one of the cheapest methods of housing tuberculous an estimated cost of

It has a capacity of seven beds at

HUSMPHI^R^F^

f—

-^^^

TT C ONTT'

^^111

lalBI

ta

^_____ 1

i

Beookie No. 90.— Rush Hospital, Country Branch, Malvern, Pa. Lean-to. View of Front Elevation ant) Floor Plans. Capacity, Cost, $400.

J

r^

-

& 7

Hastings, Architects. Patients. Estimated

(See illustration 97 for further description of this institution.)

141

Section

V

r

7

OHLN WA KTE ROOF PROJECTION

No.

91.

— Loomis

Sanatorium, Liberty, N. Y. Designed by De. Herbert Maxon King. Lean-to. OF Front Elevation and Floor Plan. Capacity,. 8 Patients. Estimated Cost, Si.ooo. (See illustrations i, 72, 73 and 108 for further description of tliis institution.)

\'iE\v

Loomis building

is

of

Sanatorium, frame

Liberty,

construction,

N.

placed

Y.,

on

Lean-to

stone

piers,

(Illustration

91).

This

covered externally with

and has a shingled roof. It is Dr. King's latest modification of a lean-to buildand is 70 feet long by 20 feet wide, divided into an open porch 20 feet wide by 48 feet long at one end, and an enclosed apartment 20 feet wide by 21 feet long at the other. There are lockers or small private dressing rooms 3 feet wide by 5 feet deep, for each patient, toilets, baths, and a central dressing hall between the rows of lockers. The enclosed apartment is heated by a large coal stove with boiler attachment to supply hot water for toilet purposes. It has a capacity for eight patients at an estimated cost of $2,000. siding

ing

Michigan State Sanatorium, Howell, Mich., Lean-to, Floor Plan 92).

(Illustration

This was a design made for a lean-to at the jMichigan State Sanatorium, but has not

been constructed.

The

building was to have been of frame, 100 feet long

by

25 feet deep,

with sitting room 15 feet wide by 25 feet deep in the centre, the porches to be 42 feet long by 24 feet deep, divided into an open ward with four dressing rooms in its rear; these rooms to be for

two patients each,

8 feet

wide by 10 feet deep, 142

fitted

with lockers, showers,

toilets

Patients' Quarters

xfc

No.

—Lean-to Type of Building

HOYrELj..MiCf-.

82.

—Michigan State

FOR A Lean-to.

Scopes & Feustmann, Architects. Capacity, 16 Patients. Estimated Cost, $3,500. (See

Sanatorium, Howell, Mich.

Floor Plan.

Design illus-

tration 74 for further description of this insitution.)

central plant. The design is worth studying and would make a convenient building for a site on a side hill as there is no rear extension in the plan. The capacity is sixteen patients at an estimated cost of $3,500.

and wash-basins and heated from a

New York 93).

It

is

State Hospital, Raybrook, N. Y., Lean-to for

to

be constructed either of brick or frame and

wings and a rear extension.

more

Women

(Illustration

This floor plan was designed for a lean-to at Raybrook, but has not yet been erected. will consist of a central section,

two

In order to make the dressing rooms in the rear extension

accessible for the patients in the wards, the wings are designed to

form an acute

The wards are on the front, forty-six feet long on the rear and thirteen feet wide opening on to a veranda nine feet wide which extends along the entire front of the building. The central sitting room is 27 feet wide by 11 feet deep and has a large, open fire-place. Behind it is a rear extension 28 feet wide by 18 feet deep, divided into a linen room, toilet room, bathroom, dressing and locker room. The plan should be noted for the arrangements made in the wards to protect the head of the beds, by a half partition which extends about three feet in the wards. The building has a capacity for sixteen patients and will cost about $3,500. angle in the rear of the building, at their junction with the central section.

fifty-four feet long

No. 93.— New York State Hospital, Raybrook, N. Y. Franklin B. Ware, Architect. Design for a Lean-to. Floor Plan. Capacity, 16 Patients. Estimated Cost, $3,500. 143

Section

V

HA.<;rMk-MT



No. 94. Municipal Sanatorium, Otisville, N. Y. Designed by Dr. Hermann M. Biggs. James D. Burt, Architect. Lean-to, No. 103. View or Front Elevation and Floor Plans. The Special Feature of this Building is an Arrangement that Forms the Patients into Groups or Units by Sl^pplying a Separate Living Room and Toilet Apartment in Connection with Each Porch. Capacity, 32 Patients. Cost, $9,000. (See Illustrations 14, 28, 59, 60, 85 and loi for further description of this institution.)

Municipal Sanatorium, This

is

Otisville,

N. Y.

Lean-to, No. 103.

(Illustration

94.)

The

a two story building, with foundations of native stone, eighteen inches thick.

walls are of frame construction, covered on the outside with shingles, stained a dark

green and trimmed white.

with matched and

The

roof

fitted boards,

is

also of shingles stained red.

and the

floors are of

wood,

all

plan of the building follows the general lines of the lean-to, but

The its

is

ceiled

oil.

The

interior

finished

in

special feature

is

an arrangement that forms the patients into groups or units by supplying a separate living

room and

toilet

apartment

in connection with

each porch.

All the patients

private dressing rooms built with low partitions, and provided with lock doors.

have

The

basement contains the heating apparatus, toilets, baths, blanket store rooms, and a recreation room which is almost above the ground. Over the centre is an attic divided into rooms which can be locked and are fitted with open shelves where trunks, dress-suit cases

and other belongings escape in the rear. for protection in

of the patients

The open

can be stored.

front faces the south,

rough weather.

Each wing is provided with a fire and is furnished with roll curtains

This building has a capacity of thirty-two patients, in

four groups of eight persons to each porch

and 144

cost about $9,000.

Patients' Quarters

T^QIJTH

—Lean-to Type

^EZVATIOM -DOEMrrOEY

of Building

BUliX):

_

Pm

1^

^

*

TTE5n=ID012 DOEimTOEY BUlLDinG

No.

Farmingdale, N. J. Designed by Dr. Hermann M. Biggs. Judell, Associated Architects. Lean-to. Front ElevaEstimated Cost, $7^00. tion ANT5 Floor Plans. Capacity, 28 Children and Two Attendants. institution.) (See illustrations 12, 19 and 27 for further description of this 0=;.

—Preventorium

Scopes

for Children,

k Feustmann, and Walter W.

The Preventorium

for Children,

Farmingdale, N.

J.,

Dormitory Building

the shack for children at Municipal (Illustration 95). constructed of holSanatorium at Otisville. The exterior walls of these pavilions are concrete foundation and low tile, covered with cement stucco, and are placed on a of edge-grain yellow concrete piers. The interiors are of frame construction, with floors buildings, all alike, the roofs are covered with shingles. There are four of these

Modified from the design

pine,

and

of

contain bathing facihties, except the second floors of the central sections. The basements eight feet high, and and the wings are arranged as sleeping wards, with open fronts, ceilings TO

I4S

Section windows

in the rear walls.

The

V

dressing rooms in the centre sections are furnished around

the walls with benches divided into individual lockers, used to store the toys and personal

belongings of the children. Over these benches, at a height of five and one-half feet, are two shelves where the blankets used during the rest hour are placed. On the rear walls are racks to hold toilet articles and in the centre is a stone wash-trough with hot and cold water faucets. Behind the dressing rooms are store rooms fitted with large pigeon-holes used instead of lockers, and the toilets arranged to be entered from the rear direct from the grounds and playrooms without tracking mud through the dressing rooms or wards. In two pavilions the second stories consist of one large play and school room, which can be entirely opened on three sides, and accommodates fifty-six children. In the other buildings the second stories are used as infirmaries, divided into two wards for four children each, with a porch on the south to which the beds can be wheeled, a nurses' room, a bath, a diet kitchen and a linen room. The pavilions have a capacity for twenty-eight patients each, and cost $7,700.

146

SECTION Patients'

Quarters

VI

—Cottage

Type

of

Building

SECTION VI Patients'

Quarters— Cottage Type

of Building

Origin of the Cottage In most of the large private sanatoria ing

is

not satisfactory for housing patients

who

Well-to-do patients usually desire

attendance.

porch which

it lias

private and cannot be overlooked

is

been found that the lean-to type

of build-

good nursing and separate apartments, and often demand a are willing to

pay

for

by other inmates of the institution.

In this

section will be found descriptions of cottages which have proven satisfactory, arranged to

house from one to eight patients, with a private room, separate porch, and toilet facilities for

modern accommo-

all

each; also cottages designed to be used as a separate unit to

date families where one or more members are tuberculous, and having rooms for a private

Cottages planned for the use of one person only, usually have but two

nurse and servants.

rooms, one for dressing and living porch.

designed by

toilet

purposes and the other practically an open sleeping and

This type of cottage

and can be

Dr. Millet

It is reported that in

many

is

generally a modification of the original structure

built for a reasonable figure.

instances patients at large public institutions are

more

contented and improve faster when given a separate room or a share in a small building with one or more congenial associates, and as some of the cottages described are very inexpensive a more careful study of the results obtained by the different methods of housing incipient patients,

may

in the future cause the construction of a larger proportion of the

cottage type of sanatorium in the place of ward buildings, for state and county tuberculosis hospitals.

Planning Cottage In designing and constructing cottages the following points should be considered. First: Each patient should have a private room and a porch which, when desired, can be screened in a way to prevent Second:

customs

it being overlooked. Cottages should be designed when possible to conform to the desires and

of the people

comfortable at Fourth:

all

who

will use

them.

buildings should be constructed of such material as will

The

Third:

make them

seasons of the year in the climate for which they are intended.

The

interior should be finished in the

most simple manner and with smooth

surfaces in order to eliminate places likely to collect dust. Fifth:

or ventilated in

much

an open porch as possible, a manner that can be regulated by an attendant, but will prevent the

The

sleeping apartment should be as

patient from shutting off the current of

like

air.

EXAMPLES OF COTTAGES Millet Sanatorium, East Bridgewater, Mass., Cottage (Illustration 96). a frame building su[)ported on cedar posts, boarded and covered with shingles.

The This

is

148

.

Patients' Quarters

No. 96.

Sanatorium, East Bridgewater, Mass. Design by Dr. C. View of Front Elevation, Floor Plan, Side and End Elevation.

roof

cottage

wide by 12

Patient.

laid at "quarter pitch"

is

other interior

The

of Building

—Millet

I

The

—Cottage Type

finish,

is

but the

12 feet wide

by

Cottage.

Estimated Cost, $200.

with the

floor is laid

Millet. Capacity,

S.

rise to

the front.

There

is

no plastering or

double with the upper layer of narrow, hard pine.

18 feet long, divided

by a

partition into a

bedroom

12 feet

open on all sides, and a dressing room 6 feet wide by 12 feet long, lighted by two windows, heated by a stove and furnished with a stationary wash-stand, running water, a toilet and a wardrobe. The rear wall is six and one-half feet high, and feet long,

faces the north

tended

for

and can be opened or closed by wooden

one person and cost about $200.00. 149

shutters.

The

building

is

in-

Section

Rush

No. 97.

VI

Hospital, Country Branch, Malvern, Pa. Brookie & Hastings, Architects. View of Front ant) Side Elevations, antj Floor Plan. ^ Capacity, 2 Patients. Estimated Cost,

Cottage.

Rush This

is

Hospital, Country Branch, Malvern, Pa., Cottage (Illustration 97).

a small frame building placed on 4 x 4 timber posts and roofed with patent roofing

by 24

and has a porch eight feet wide at one end. The by 15 feet long, and a dressing room 16 feet wide by 7 feet deep. The bedrooms can be thrown into one large room by removing the portable partition between them. The arrangement of the windows for throwing open the interior should be noted. This little building is well designed for cheap and simple housing. The capacity is two patients and estimated cost of construction $300.00. 18 feet wide

feet long

paper.

It

is

building

is

divided into two bedrooms, each 8 feet wide

Patients' Quarters

—Cottage Type of Building

/ 7'X 16'

o o

ROOM

llKI-'.^'mNg

rx

16'

CMHIfiAl

'WUH /arx

No. 98.

r H-

ar

—Adirondack

Cottage Sanitarium, Saranac Lake, N. Y. Cottage. View of Front Elevation and Floor Plan. Capacity, 4 Patients. Estimated Cost, $400.

Adirondack Cottage Sanitarium, Saranac Lake, N. Y. (Illustration 98). This is placed on stone piers and is of frame construction, j^i feet wide by 19 feet deep.

building

It was built of second-hand lumber and other material obtained from older buildings which had been torn down and was one of the first experiments in shack construction at this Sanitarium. As the patients at this institution are given as much privacy as possible, the porch is divided into small cubicles, and the partitions between the patients' beds

are erected to a height of six feet.

The

room

dressing

another building.

is

heated by a stove, but the

It has a capacity of four patients at

toilet facilities are

an estimated cost

provided in

of $400.00.

Section

VI



No. 99. Association Sanatorimn, Louisville, Ky. D. X. Murphy & Brother, Architects. Cottage. View of Front and Side Elevation and Floor Plan. Capacity, 12 Patients. Estimated Cost, $2,250.

Association Sanatorium, Louisville, Ky., Men's Cottage (Illustration 99). a frame cottage on concrete piers, covered with a patent roofing, 36 feet wide 22 feet deep, without the porch or the extension. It consists of a central sitting

This Vjy

is

room 10 and two

feet

wide by 15 feet long, and four private rooms, two 10 feet wide by 12

feet

deep

by 14 feet deep. The toilets and lavatories are in the rear extension, which is 13 feet wide by 7 feet deep, and the building is surrounded on three sides by a porch twelve feet wide. The floor plan of this building is very much like the cottages at the Iowa State Sanatorium, and for some purposes is an improvement over them because of the private rooms. It has a capacity for twelve patients and cost $2,250. 12 feet wide

152

Patients' Quarters

No. 100.

—^White

Haven

— Cottage Type of Building

Sanatoritim, "White Haven, Pa. Cottage. View of Front and Side Capacity, 8 Patients. Estimated Cost, $800.

Elevation and Floor Plan.

The White Haven Sanatorium, White Haven, Pa., Cottage (Illustration 100). This building, placed on wooden posts, is of a cheap frame construction, covered externally with siding and roofed with composition roofing. There are two open air rooms 15 feet wide by 16

feet long, protected by glass and sash windows in winter and canvas curtains summer, both hung from the top. The two pavilions house eight patients and are connected by a dressing room 7 feet wide by 10 feet long, which is heated by a small stove and used in common by all. This plan for a cottage may be constructed to house only one or two patients in each pavilion, when all the dimensions except the size of the dressing room should be cut down. The estimated cost is $800.00.

in

153

Section

No.

loi.

—Municipal Cottage.

Otisville, N. Y. Designed by Dr. Hermaxx of Front ELE^•ATIO^- and Floor Plan. Capacity, 8 Patiexts. Estimated Cost, Si ,500.

Sanatorium, \'ie\v

The Municipal Sanatorium, This

is

a

VI

frame building on brick

Otisville,

piers,

N. Y., Cottage

M. Biggs.

(Illustration

loi).

covered with shingles artistically stained and

trimmed and has a very attractive appearance. It is 58 feet long by 19 feet wide with a room in the centre 15 feet wide by 19 feet deep, which contains the patients' lockers and a fireplace. The porches, 20 feet wide by 19 feet deep, are divided by a partition eight feet high, into two rooms 10 feet wide by 1 2 feet deep, for two patients each. The verandas in front of the porch rooms are six feet wide. There are no toilets, baths or dressing sitting

room, as this cottage toilet

and washroom.

to remodel

it

may

is

used in connection with another building containing a central it is a cheaply constructed bmlding with a floor plan easy

As

who wish to add a pavilion The estimated cost is $1200.00.

be used by small communities

hospital for housing tuberculous patients.

154

to their local

Patients' Quarters

No. 102.

—Cottage Type

of Building

—Plainfield

General Hospital, Plainfield, N. J. A. L. C. Marsh, Architect. Cottage View of Front and Side Elevation, Floor Plan. Capacity, Estimated Cost, $3,000. Note. This is a Modified Plan of the Municipal

Ward for Tuberculous Patients. 8 Patients.



Sanatorium Cottage.

Plainfield General Hospital, Plainfield, N. J., Cottage Ward for Tuberculous Patients (Illustration 102). This building is a design modified from the plans of the Otisville Cottage.

It

is

sixty-eight feet long, of frame construction, covered with shingles

and placed on stone piers. There is a solid partition running directly through the centre dividing the two sides of the building into two separate sections, making two sitting rooms 13 feet wide by 19 feet long on the front, and two dressing rooms 8 feet wide by 12 feet long in the rear. The elevation has a slightly different arrangement for the windows in the centre of the building and is supported by large round columns which gives it a very attractive appearance.

The capacity

is

eight patients at an estimated cost of $3,000. 15s

Section

VI

O O 7)>v A'.s.s i^j^T /-:nrT^

,S'i7

T

;a;i--^

:
I

L

<

J

-Pct

=C=r:

No. 103.— Iowa State Sanatorium, Oakdale, la. Design by Dr. H. E. Kirschner. H. F. Liebbe, .\rchitect. Cottage. View of Front and Side Elevation ant) Floor Plan. Capacity, Estimated Cost, .$1,500. CSee illustrations 24, 29 and 84 for further description of this 8 Patients. institution.)

156

Patients' Quarters

—Cottage Type

Iowa State Sanatorium, Oakdale, on brick

tage, placed

large central sitting

and

is

Cottage

la.,

by

a dressing

15 feet deep, about

room

17 feet wide

which receives plenty

is

built a twelve foot

is

9 feet it is

deep, containing

not enclosed by the

more comfortable when only

It is claimed for this structure that part of the

tered from storms and will receive sunlight from

It consists of a

roof.

which

by

of sunlight as

building was planned for ten patients but

housing eight.

This cot-

(Illustration 103).

frame construction with a shingle

17 feet wide

toilet facilities,

The

porch.

room

In the rear

wide porch. lockers

piers, is of

of Building

porch

will

always be shel-

some direction during the

entire day.

Those who have used the design speak very highly of the arrangement, as there is room for all the beds on the sheltered side, and it is not necessary to enclose a portion of the porch as is done where there is only one exposure. Larger lockers should be placed in the dressing room and better toilet facilities At the Iowa State Sanatorium this provided, such as a shower bath and extra toilets. cottage has been very satisfactory and ten of a like design have been erected at a cost of about $1,400 each.

Adirondack Cottage Sanitarium, Saranac Lake, N. Y., Wheeler Cottage (Illustration 104). This cottage

is

on a

placed

foundation of native stone and

is

of

frame construction, covered wnth a inch

four

veneer

brick

leaving an air space

i

externally,

inch wide be-

tween the brick and the sheathing. This method of construction

was adopted

in order to

make

a

warm,

dry building, and to save repairs and

The

paint on the exterior.

blocked

and

tin.

On

the

roof

interior

is

ceilings are finished in plaster

wood

lath with hard

hard wood

floors

of

walls

on

wood trimming,

and coved bases with

flush joints.

Everything in

been arranged

There

is

in

a

ijU

this building has

compact form.

^Jlf

direct sunlight in the sleeping

rooms, which are small, but contain

«m

a closet, ventilators and are connected

==

with a private porch for each patient.

The

cottage consists of only one story,

but has a

cellar

under the entire build-

No.

ing which contains a hot water heating

apparatus.

104.— Adirondack Cottage Saranac Lake, N. Y. Scopes Architects.

\\'heeler

Sanitaritim,

& Feustmann,

Cottage.

Front Elevation and Floor Plan.

It has a capacity for four

4 Patients.

patients and cost .$4,000.

View of Capacity,

Estimated Cost, $4,000.

(See

illustrations 63, 98 and 109 for further description of this institution.)

157

Section

No.

105.

— Gaylord

Cottages.

V

Farm, Wallingford, Conn. Brow & von Berex, z\rchitects. Connected View of Front and Side Elevations and Floor Plans. Capacity of EACH Cottage, 8 Patients.

Estimated Cost,

$3,000.

Gaylord Farm, Wallingford, Conn., Connected Cottages (Illustration 105). These cottages, of frame construction, are placed on stone foundations and stone piers with cellars under the centres, and covered externally with shingles. They are artistically and conveniently designed, 35 feet wide by 26 feet deep, with a porch across the entire front and back, ten feet wide. The front porch of

one cottage

is

connected with the rear porch of the next

by an open corridor 40 feet long by 13 feet wide, which is used as a sleeping porch for patients. In the illustration this corridor is

ened three

shown ten

feet wide,

but

it

has been broad-

feet in order to give better protection against

storms.

There is a sitting room in the centre, 13 feet wide by 14 feet deep, four patients' rooms on the sides 10 feet wide by 12 feet deep, and a room in the rear 9 feet wide by 6 feet deep, containing a toilet and bath. The capacity is

for eight patients at

an estimated cost of $4,000. 158

Patients'

Quarters— Cottage Type

of Building

No. io6.— Barlow Sanatorium, Los Angeles, Cal. Designed by Dr. W. Jarvis Barlow. Cottage. View of Front and Side Elevations and Floor Plan. Capacity, 2 Patients. Estimated Cost, $500.

Barlow Sanatorium, Los Angeles, ing

is

supported on stone piers and

wide by 12 feet deep.

There

is

is

a five

Cal., Cottage (Illustration 106). This buildframe construction, with a shingle roof, 20 feet foot open porch along the north side and both ends; of

the outside of the cottage and the porch are painted a seal 159

brown and the

shingles of the

Section



VI

No. 107. Portland Open Air Sanatorium, Portland, Ore. Whidden & Lewis, Architects Cottage. \'ie\v of Front axd Side Elevation and Interior. Capacity, 2 Patients. Estimated Cost, $1,000. (See illustrations 8 and 16 for further description of this institution.) 160

Patients' Quarters

The

roof, green.

but not tition

may

ceiled,

— Cottage Type of Building

interior is finished in surface

and

is

lumber dressed with

divided into two rooms each lo feet wide

runs transversely from the floor to the roof and

by

oil

and varnished,

12 feet deep.

The

par-

but pierced by a door which boarded up but can be opened

plain,

is

The north side of the cottage is Each end and the south side are boarded to a height of three feet from the floor, the space above this to the plate being protected by copper wire screening, and provided with awnings which can be let down in wet weather. The doors, the space between the rafters and three inches under the eaves on each side, left open for ventilation, by

be used

necessary.

if

window.

a hinged

are screened.

On

The

diameter.

the roof over the partition

is

an iron ventilator sixteen inches

in

room is placed in a small separate building at the rear and divided and toilet rooms, well screened and ventilated. This is a good plan

toilet

into bath, dressing

where earth closets are used, as they can be emptied without disturbing the patients. Warm water is supplied for toilet purposes by a contrivance operated very successfully in southern California, all the year round by direct sunlight, which is called a "solar heater" and is placed on the roof. The capacity of the cottages is two patients and it cost, including toilet, S700.00.

The Open Air Sanatorium, Portland, building

is

placed on stone piers and

is

Ore., Cottage (Illustration 107).

This

frame construction, externally covered with

of

It is 16 feet wide by 21 feet deep and has a above the ground to produce an air space, which is enThe interior is divided into an open room 16 feet wide by 13 closed with lattice work. feet deep, a bath room 4 feet wide by 8 feet long, a little hall and two closets both 4 feet wide by 3 feet deep. It is nicely finished in hard wood and sealed with narrow, selected

stained shingles and trimmed with white. floor raised

boards.

two and a

There

is

an

half feet

air

space between the ceiling and the roof, in order to prevent the

Both the

direct rays of the sun heating the interior during the middle of the day.

air

space under the floor and that above the ceiling should be noted, as they are a necessary part of cottage construction in

damp

or hot countries.

A number

of these cot-

more was about $1,000. Loomis Sanatorium, Liberty, N. Y.,The Orchard Cottage (Illustration 108). This building is placed on a stone foundation, one story high and of frame construction covered externally and roofed with shingles. The interior is finished in plaster on wooden tages have been built

and are

said to be very comfortable, being classed with the

substantial type of open air buildings, as the cost of construction

It is heated by direct radiation in the lath, with hard wood floors and cypress trimmings. rooms, from a hot water boiler placed in the cellar which has been excavated under the

entire building.

The bedrooms

are about 9 feet wide

by 10

feet deep,

made

small inten-

on the porches. The plan is of interest and will There is a commodious please those who believe in utilizing corners and other small places. attic which can be divided into several rooms, a smaU combined living and drawing room 12 feet wide by 18 feet long, which has a large fireplace, a kitchen 10 feet wide by 11 feet The cottage is more like a pleasant country house than long, a bath and a maid's room. tionally to encourage the patients to live

an

institutional building

and has a capacity

for four patients or a small family

about $3,500. Adirondack Cottage Sanitarium, Saranac Lake, N. Y.,

and can be

built at a cost of

The Nathan Cottage

frame construction, covered externally with yellow The cottage is about 42 feet terra-cotta brick veneer placed on native stone foundation. wide by 30 feet deep, with a veranda having a southern exposure, and protected by glass (Illustration 109).

This building

is

of

and sash frames on the north, east and west, arranged so that its roof does not prevent The sitting room, 14 feet wide by 20 feet deep, is sunlight from entering the rooms. TI

161

Section

No. io8.

—Loomis Sanatorium, Liberty, N. Y.

\'iEw OF

Scopes

VI

& Feustmann, Architects.

Froxt axd Side Elevations and Floor Plan.

$3,200.

(See illuslrations

i,

72, 73

and 91

Capacity, 4 Patients.

Orchard Cottage. Estimated Cost.

for further description of this institution.)

162

Patients' Quarters

No. 109.

— Cottage Type of Building

—Adirondack Cottage Sanitarium, Saranac Lake, N. Y.

Nathan Cottage.

Scopes

& Feustmann,

Architect

View of Front Elevation and Floor Plan.

Estimated Cost, $5,000.

Cap.acity, 4 Patient (See illustrations 63, 98 and 104 for further description of this institi

tion.)

placed in the rear of the building and reached by a hall from the front door; there are tw

bedrooms

12 feet wide

by 10

feet

deep on either side of the hall and two 14 feet wide b

window opening. Th by transoms and all windows and doors are brought flush with th ceiling. Each bedroom is heated and has a large closet. The cottage will accommodat four persons, and cost, including furnishing, $5,000. 10 feet deep at the sides of the sitting room, a combination door and

building

is

ventilated

163

Section

VI

rfl^-3TrL00J2 PL AM No.

Pines Sanatorium, Stevens Point, Wis. Designed by Dr. H. E. Dearholt. Cottage. View of Front and Side Elevations and Floor Plan. Capacity, 8 Patients. Cost, $4,000.

no.— River

River Pines Cottage Sanatorium, Stevens Point, Wis. (Illustration no). roof is 64 feet wide by 30 feet deep, of frame construction, with a shingle and is placed on a brick foundation. It has two floors, both planned alike, and the arrangement of the rooms and porches is interesting. Each patient is supplied with a private room about twelve feet square, a closet and a sleeping porch about nine feet square, having two exposures, one south and the other either east or west, the porches being arranged so that some portion of them cannot be overlooked from other parts of the building. The bathroom, toilet, lavatory and main entrances are placed on the north and con-

This cottage

nected with

The

all the rooms by a small hall. cottage has a capacity for eight patients and the estimated cost

is

$4,000.

COLUMBIA UNIVERSITY LIBRARIES

0037545914

DUE DATE

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1

1999

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Printed in

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Tuberculosis hospital and sanatorium construction - Tucson Historic

HX64075761 RA967 C23 Tuberculosis hospita Pi'a r RECAP luberculosis Hospital and Sanatorium Construction WRITTEN FOR THE NATIONAL ASSOCIATION ...

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